Freezing/festination during motor tasks in early-stage Parkinson's disease: A prospective study

Delval, Arnaud; Rambour, M.; Tard, Céline; Dujardin, Kathy; Devos, David; Bleuse, S.; Defebvre, Luc; Moreau, Caroline

doi:10.1002/mds.26762

Cited by 35 publications

(42 citation statements)

References 52 publications

(68 reference statements)

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“…Furthermore, the potential role of anxiety during the metronome condition should not be overlooked since it is highly prevalent in freezers [ 41 ] and can lead to freezing [ 42 ]. In the present study, the single imposed frequency (4 Hz, previously demonstrated to trigger freezing [ 30 ]) was higher than the patient’s self-generated frequency. Auditory cueing appears to increase the priority given to maintaining frequency because the amplitude decreased for the feet (but not for the hands).…”

Section: Discussioncontrasting

confidence: 49%

“…severe hypokinesia) for at least 0.5 s; this might not be totally specific for freezing phenomena. In the absence of PD, freezing episodes of the upper or lower limbs are rarely observed in elderly patients [ 30 ]. However, this does not explain the differences observed when comparing upper limb and lower limb effectors.…”

Section: Discussionmentioning

confidence: 99%

“…This hypothesis is strengthened by the fact that all 15 patients presented FoG during an on-medication FoG trajectory but only 11 experienced freezing during a 4 Hz foot-tapping task. In early-stage PD, the production of bimanual movements in time with a metronome was a very sensitive freezing trigger [ 30 ]. However, this trigger might be inadequate in advanced PD patients, who present FoG and lower-limb freezing more frequently.…”

Section: Discussionmentioning

confidence: 99%

“…The use of external cue can be very useful to trigger freezing [ 23 , 26 , 29 , 30 ]. We previously showed that the use of an external cue at an appropriate frequency was associated with an elevated occurrence of episodic rhythmic disorders (at around 4 Hz) [ 30 ]. However, those segmental freezing phenomena have not been studied in patients with advanced PD who suffer from residual off-FoG, despite optimized dopatherapy.…”

Section: Introductionmentioning

confidence: 99%

“…We hypothesized that freezing equivalents would be more frequent in the presence of a metronome since a metronome could better trigger these segmental freezing episodes [ 30 ]. Indeed, freezing episodes during diadochokinetic tasks mainly occur at between 3 and 5 Hz [ 30 ]. As a secondary objective, we expected that the reliability of these measurements between 2 sessions would be high.…”

Section: Introductionmentioning

confidence: 99%

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Freezing during tapping tasks in patients with advanced Parkinson’s disease and freezing of gait

Delval¹,

Defebvre²,

Tard³

2017

PLoS ONE

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IntroductionParkinson’s disease patients with freezing of gait also experience sudden motor blocks (freezing) during other repetitive motor tasks. We assessed the proportion of patients with advanced PD and freezing of gait who also displayed segmental “freezing” in tapping tasks.MethodsFifteen Parkinson’s disease patients with freezing of gait were assessed. Freezing of gait was evaluated using a standardized gait trajectory with the usual triggers. Patients performed repetitive tapping movements (as described in the MDS-UPDRS task) with the hands or the feet in the presence or absence of a metronome set to 4 Hz. Movements were recorded with a video motion system. The primary endpoint was the occurrence of segmental freezing in these tapping tasks. The secondary endpoints were (i) the relationship between segmental episodic phenomena and FoG severity, and (ii) the reliability of the measurements.ResultsFor the upper limbs, freezing was observed more frequently with a metronome (21% of trials) than without a metronome (5%). For the lower limbs, the incidence of freezing was higher than for the upper limbs, and was again observed more frequently in the presence of an auditory cue (47%) than in its absence (14%).ConclusionAlthough freezing of the lower limbs was easily assessed during an MDS-UPDRS task with a metronome, it was not correlated with the severity of freezing of gait (as evaluated during a standardized gait trajectory). Only this latter was a reliable measurement in patients with advanced Parkinson’s disease.

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Freezing during tapping tasks in patients with advanced Parkinson’s disease and freezing of gait

Delval¹,

Defebvre²,

Tard³

2017

PLoS ONE

Self Cite

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Prevention of Falls in Parkinson's Disease: Guidelines and Gaps

Camicioli

Morris

Pieruccini‐Faria

et al. 2023

Movement Disord Clin Pract

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BackgroundPeople living with Parkinson's disease (PD) have a high risk for falls.ObjectiveTo examine gaps in falls prevention targeting people with PD as part of the Task Force on Global Guidelines for Falls in Older Adults.MethodsA Delphi consensus process was used to identify specific recommendations for falls in PD. The current narrative review was conducted as educational background with a view to identifying gaps in fall prevention.ResultsA recent Cochrane review recommended exercises and structured physical activities for PD; however, the types of exercises and activities to recommend and PD subgroups likely to benefit require further consideration. Freezing of gait, reduced gait speed, and a prior history of falls are risk factors for falls in PD and should be incorporated in assessments to identify fall risk and target interventions. Multimodal and multi‐domain fall prevention interventions may be beneficial. With advanced or complex PD, balance and strength training should be administered under supervision. Medications, particularly cholinesterase inhibitors, show promise for falls prevention. Identifying how to engage people with PD, their families, and health professionals in falls education and implementation remains a challenge. Barriers to the prevention of falls occur at individual, environmental, policy, and health system levels.ConclusionEffective mitigation of fall risk requires specific targeting and strategies to reduce this debilitating and common problem in PD. While exercise is recommended, the types and modalities of exercise and how to combine them as interventions for different PD subgroups (cognitive impairment, freezing, advanced disease) need further study.This article is protected by copyright. All rights reserved.

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Stretchable triboelectric sensor for measurement of the forearm muscles movements and fingers motion for Parkinson's disease assessment and assisting technologies

Anaya

Yuce

2020

Med Devices & Sens

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Parkinson's disease (PD) is a degenerative, neurological disease that causes motor dysfunctions on the patient. Currently, the symptoms and progression of the disease are assessed by physicians who diagnose through careful observation, according to the Movement Disorder Society (MDS)-sponsored Revision of the Unified Parkinson's Disease Rating Scale (UPDRS). In this manuscript, we report a portable sensor device based on a flexible Triboelectric Nanogenerator (TENG) formed from a dielectric material with a size of 4 cm × 3.5 cm and an aluminium (Al) electrode with dimensions of 2 mm × 3 mm, to monitor the movement of forearm muscles and tendons. When the hand or fingers extend or flex, the short gap between the dielectric polymer and the small conductor changes, generating a voltage due to triboelectric contact. The device is used to assess localized bradykinesia and rigidity of fingers and hands, as well as wrist and arm tremors. The voltage signal of the proposed sensor shows different waveform shapes, time duration and amplitude for each level of classification from 'normal' to 'moderate' status, described on the MDS-UPDRS examination of hand movement, finger tapping and pronation-supination movement. Hence, we demonstrated that the proposed sensor can potentially be used for quantification of the symptoms and diagnosing. In addition, single finger motion tracking is also achieved by placing the triboelectric sensor in different positions around the forearm, close to the tendon connected to the finger under test. This way we avoid the placement of the sensor directly on the fingers, improving comfortability and long-term wearability. The presented TENG sensor is fully integrated with the processing and the transmission board exploring new opportunities for triboelectric transducers in small motion detection of muscles. The future aim of this research is to provide real-time monitoring of the disease progression as feedback for personalized treatment of the PD patients.

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Freezing/festination during motor tasks in early-stage Parkinson's disease: A prospective study

Abstract: Freezing and festination of the upper and lower limbs are observed soon after the diagnosis of PD and may be early biomarkers for disease progression. © 2016 International Parkinson and Movement Disorder Society.

Cited by 35 publications

References 52 publications

Freezing during tapping tasks in patients with advanced Parkinson’s disease and freezing of gait

Freezing during tapping tasks in patients with advanced Parkinson’s disease and freezing of gait

Prevention of Falls in Parkinson's Disease: Guidelines and Gaps

Stretchable triboelectric sensor for measurement of the forearm muscles movements and fingers motion for Parkinson's disease assessment and assisting technologies

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