The validation of an Italian version of the Freezing of Gait Questionnaire

Abstract

Freezing of gait (FOG) is a common and disabling symptom in Parkinson's disease (PD) and its staging is complex because of its episodic nature. Patient-reported assessments are essential in evaluating this disabling symptom. The Freezing of Gait Questionnaire (FOG-Q) is considered a valid and reliable tool for the assessment of FOG severity. The aim of our study was to validate the Italian version of FOG-Q and to investigate for its association with several clinical aspects of PD. Fifty-one PD patients were administered the FOG-Q and the timed up and go test. Moreover, patients were evaluated for the unified PD rating scale (UPDRS), the Hoehn and Yahr Scale (H&Y) and the falls-efficacy scale [FES(S)]. Mean (SD) FOG-Q item scores ranged between 1.5 and 2.7 (1.0-1.4); corrected item-total correlations ranged between 0.63 and 0.86. The total FOG-Q score ranged between 0 and 24, with a mean + SD of 12.6 (6.2) and a median (q1-q3) of 12 (9-17). Reliability was 0.91. FOG-Q correlated with H&Y (0.36, p = 0.0091), UPDRS part III (rS = 0.27, p = 0.054), PD duration (rS = 0.35, p < 0.01), FES(S) (rS = 0.58, p < 0.001) and the timed up and go test (rS = 0.51, p = 0.001). Non-significant positive correlations were observed for dyskinesia and motor fluctuations. Our study validates the Italian version of the FOG-Q, in that it results being a reliable instrument for assessing FOG in PD patients.

Clinimetrics of the Freezing of Gait Questionnaire for Parkinson Disease During the “off” State

“…Regarding convergent validity, the FOGQ showed a high correlation with the UPDRS (freezing item) since both measures assess the same construct. Similar correlation coefficient values were found in previous studies in the "on" state (Oliveira Baggio et al, 2012;Giladi et al, 2000;Giladi et al, 2009;Nilsson & Hagell, 2009;Nilsson et al, 2010;Tambasco et al, 2015). A moderate association was found between the FOGQ and balance measures (BBS and FR).…”

“…The ceiling and floor effects, as well as the skewness of the total score of FOGQ, verify the acceptability of data, which is consistent with earlier studies during "on" state (Nilsson & Hagell, 2009;Nilsson et al, 2010;Tambasco et al, 2015).…”

“…The last 4 items assess FOG frequency (item 3) and duration (items 4 to 6) (Giladi et al, 2000). The clinimetric properties of the FOG questionnaire have been assessed in several studies, but only in the "on" state (Oliveira Baggio, Curtarelli, Rodrigues & Tumas, 2012;Candan, Çatıker & Özcan, 2019;Giladi et al, 2009;Nilsson & Hagell, 2009;Nilsson et al, 2010;Tambasco et al, 2015;Vogler, Janssens, Nyffeler, Bohlhalter & Vanbellingen, 2015).…”

Allelic variant in SLC6A3 rs393795 affects cerebral regional homogeneity and gait dysfunction in patients with Parkinson’s disease

“…Consistently, our further correlation analysis displayed that ReHo values in right ITG were negatively related to TMT gait subscale scores and positively associated with FOG-Q scores in PD-AA group. TMT gait subscale and FOG-Q both showed excellent validity and reliability for the valuation of different gait characteristics and had been widely used in PD researches (Kegelmeyer et al., 2007; Tambasco et al., 2015; Park et al., 2018; Li et al., 2018). Besides, the lower scores of TMT gait subscale represents more serious gait deficits, in contrast, the higher scores of FOG-Q means more serious FOG.…”

“…Subjects were evaluated by face-to-face interviews and clinical associative scales. Unified Parkinson’s Disease Rating Scale section III (UPDRS-III) (Goetz, 2003), Tinetti Mobility Test (TMT) (Kegelmeyer et al., 2007), Freezing of Gait Questionnaire (FOG-Q) (Tambasco et al., 2015) and Timed Up and Go (TUG) test (Chantanachai, Pichaiyongwongdee & Jalayondeja, 2014) were performed to detect motor symptoms in PD. Moreover, Hamilton Anxiety Rating Scale (HAMA) (Kummer, Cardoso & Teixeira, 2010), 17-item Hamilton Rating Scale for Depression (HAMD-17) (Worboys, 2013), Apathy Scale (AS) (Leentjens et al., 2008), Epworth Sleeping Scale (ESS) (Schrempf et al., 2014) and Fatigue Severity Scale (FSS) (Valderramas, Feres & Melo, 2012) were used to evaluate the non-motor manifestations in PD.…”