Document Detail

Obstacle avoidance to elicit freezing of gait during treadmill walking.
MedLine Citation:
PMID:  19938174     Owner:  NLM     Status:  MEDLINE    
Freezing of gait (FOG) is a common and disabling feature of Parkinson's disease (PD). Detailed pathophysiological studies are hampered by the fact that FOG episodes are difficult to elicit in a gait laboratory. We evaluated whether the need to avoid sudden obstacles on a treadmill can provoke FOG. We included 21 PD patients (15 with self-reported off-period FOG). Patients were tested in the off-state. FOG during overground walking was assessed using a standardized gait trajectory and axial 360 degrees turns. Subsequently, patients walked on a motorized treadmill with suddenly appearing obstacles that necessitated compensatory stepping. Performance was videotaped, and presence of FOG was scored visually by two independent raters. Thirteen patients showed FOG during overground walking. During treadmill walking, obstacle avoidance was associated with 13 unequivocal FOG episodes in eight patients, whereas only one patient froze during undisturbed treadmill walking (Wilcoxon z = -2.0, P = 0.046). FOG episodes elicited by obstacle avoidance were brief (typically <1 s). Almost all episodes were provoked when subjects had a longer available response time. In conclusion, suddenly appearing obstacles on a treadmill can elicit FOG in a controlled laboratory setting. However, the moving treadmill and the obstacle both act as cues, which apparently help to immediately overcome the provoked FOG episode. This may limit the ecological validity of this new approach.
Anke H Snijders; Vivian Weerdesteyn; Yolien J Hagen; Jacques Duysens; Nir Giladi; Bastiaan R Bloem
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  25     ISSN:  1531-8257     ISO Abbreviation:  Mov. Disord.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-04-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  57-63     Citation Subset:  IM    
Department of Neurology and Parkinson Centre Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, 6500 HBNijmegen, The Netherlands.
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MeSH Terms
Exercise Test / methods
Freezing Reaction, Cataleptic / physiology
Gait Disorders, Neurologic / diagnosis*,  etiology*
Middle Aged
Outcome Assessment (Health Care) / methods
Parkinson Disease / complications*
Statistics, Nonparametric
Video Recording / methods
Walking / physiology*

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