Freezing Gait in Parkinson's Disease

Abstract

Freezing is a well-known problem in Parkinson''s disease (PD) and is characterized by an abrupt difficulty in starting or continuing rhythmic and repetitive movements. We utilized a questionnaire in order to assess the occurrence of the freezing gait phenomenon (FG) in a population of 100 consecutive PD patients. Our PD population included 70 males and 30 females, with a mean age of 61.1 ± 9.1 years. Mean duration of PD was 6.5 ± 4.0 years. 92/100 patients were under L-Dopa treatment. The FG phenomenon occurred in 60% of patients. It appeared on average 4.8 years after the beginning of PD; in 16% of the cases it was evident before starting L-Dopa treatment. FG was more frequent among female patients. There was no significant correlation between the occurrence of FG and the age of the patients; on the other hand, a significant correlation was found with the duration of the disease (p < 0.001). FG occurred more frequently in the subgroup of patients with the akinetic form (odds ratio: 3.05); whilst an opposite tendency was evident in the subgroup with the tremor predominant form (odds ratio: 0.29).

Validity of the Brazilian version of the freezing of gait questionnaire

“…Our study found that around 47% of patients with PD that attended a Brazilian specialized movement disorder clinic reported FOG. Other previous studies reported variable findings, and this large variability may be probably explained by methodological differences such as the criteria to identify FOG and by the clinical characteristics of the sample evaluated [14][15][16] . Our patients with PD and FOG had a longer disease duration compared to patients without it, which is consonant with previous studies showing a strong association between FOG and the duration and severity of the disease 4,17 .…”

Randomized Controlled Trial of Community-Based Dancing to Modify Disease Progression in Parkinson Disease

“…This is not surprising as it is well known that FOG occurs more frequently as PD progresses. 40,41 It is interesting, though, that the Tango group presented no differences in FOG from baseline to 12 months, suggesting that exercise may delay the progression of FOG. This seems feasible, as tango dancing requires many starts, stops, turns, and movement in confined spaces, thereby incorporating direct practice of walking in the situations that commonly provoke freezing.…”

Podokinetic after-rotation in Parkinson disease

“…These falls confer an eight fold greater risk for hip fracture compared to falls during straight walking (Cumming and Klineberg, 1994). Moreover, turning frequently triggers freezing, a sudden interruption of ongoing movement, possibly further increasing fall risk (Giladi et al, 1992, Lamberti et al, 1997, Schaafsma et al, 2003, Bloem et al, 2004. Gordon et al (1995) demonstrated that the somatosensory system involved in directional control of locomotor trajectory through foot contact with the floor, the podokinetic (PK) system, is adaptable in healthy individuals.…”