Freezing of gait (FOG) is common and debilitating in Parkinson's disease (PD) [1], and significantly contributes to the occurrence of falls [2]. To prevent falls and fall-related injuries, timely detection of FOG in clinical practice is needed, as this can be the start of tailored interventions [3]. However, provoking FOG in a clinical environment is challenging, for several reasons. First, freezing is provoked by constraints in the physical environment, and the typically wide and well-lit hospital corridors are not ideal to provoke FOG. Moreover, clinicians are usually on a tight schedule and do not always have time to perform a complete FOG-provoking test battery [4]. It is therefore important to identify the most effective task * Correspondence to: Jorik Nonnekes, MD, PhD, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: jorik.nonnekes@radboudumc.nl. to provoke FOG. Stepping in place and rapid turning on the spot are both effective ways to provoke FOG [5][6][7][8]. However, these two tests have not been compared back to back. Moreover, it is unknown whether combining both tests yields a higher sensitivity than either test alone.To answer these questions, we included 16 patients with PD and subjective experience of daily FOG, as determined using the N-FOGQ [9]. Mean age of these patients was 70 years (range 51-89 years), with a mean disease duration of 10 years (range 3-20), mean MDS-UPDRS subsection III score of 36 (range 24-49) and mean N-FOGQ score of 19 (range 10-25). Hoehn and Yahr staging showed a modal score of 2 (range 2-4). All patients were examined in a practically defined OFF state, i.e., >12 hours after intake of the last dose of dopaminergic medication.
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