Freezing of gait (FOG) is a common symptom in the late stages of Parkinson’s disease and related disorders. Videos are the gold standard method to conduct FOG scoring; however, the measurement accuracy of FOG scoring based on videos has not been formally assessed, despite its use in previous studies. This study aimed to calculate the measurement accuracy of video-based FOG scoring. Three evaluators scored the FOG based on 157 video data points collected from 21 patients using an annotation tool. One evaluator measured the intra-rater reliability of the retest. The total duration of observed FOG, percentage of the time spent with FOG during the walking task (%FOG), and FOG phenotypes (shuffling, trembling, and complete akinesia) were evaluated. Intraclass correlation coefficients were used to determine the intra- and inter-rater reliabilities. The duration of FOG and %FOG showed good measurement accuracy for both intra-rater and inter-rater reliabilities. However, the FOG phenotypes showed poor measurement accuracy in inter-rater reliability. These results indicate that the temporal characteristics of FOG can be scored with a high degree of measurement accuracy, even with different evaluators; conversely, the FOG phenotypes need to be scored by several evaluators.
Atlantoaxial rotatory subluxation (AARS) is an uncommon disease with a greater prevalence in children than adults. So far there has only been one report of AARS after surgery related to ventriculoperitoneal (VP) shunting. We present a new case of AARS closed reduction treatment after VP shunt removal in an 8-year-old girl with wound pain on the back of her head and torticollis after surgery. Her head was rotated in the spine-lateral position during surgery. The diagnosis of AARS was established by 3D-computed tomography. The rotatory subluxation was cured after cervical traction therapy. The successful closed reduction was the consequence of early detection and conservative treatment, which are important constituents in the management of AARS.
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