Association between Severity of Freezing of Gait and Turning Characteristics in People with Parkinson’s Disease

Abstract

For people with Parkinson’s disease (PD) with freezing of gait (FOG) (freezers), symptoms mainly exhibit as unilateral motor impairments that may cause difficulty during postural transitions such as turning during daily activities. We investigated the turning characteristics that distinguished freezers among people with PD and analyzed the association between the New Freezing of Gait Questionnaire (NFOGQ) scores and the gait characteristics according to the turning direction for the affected limbs of freezers. The study recruited 57 people with PD (27 freezers, 30 non-freezers). All experiments measured the maximum 180° turning task with the “Off” medication state. Results revealed that the outer ankle range of motion in the direction of the inner step of the more affected limb (IMA) was identified to distinguish freezers and non-freezers (RN2 = 0.735). In addition, higher NFOGQ scores were associated with a more significant anteroposterior root mean square distance of the center of mass in the IMA direction and a greater inner stance phase in the outer step of the more affected limb (OMA) direction; explanatory power was 50.1%. Assessing the maximum speed and turning direction is useful for evaluating the differences in turning characteristics between freezers and non-freezers, which can help define freezers more accurately.

Convolutional neural network-based detection of early-stage Parkinson’s disease using the six-minute walk test

“…Axial rigidity, increased postural tone, en bloc turning, FOG, and loss of intersegmental exibility may be evident during gait in PD, particularly in walking and turning gait [39][40][41][42]. Speci cally, individuals with early-stage PD experience a reduced range of motion at the hip joint [43], asymmetric tremors, decreased coordination [44], and reduced postural stability control [45] during gait, which exacerbate with progression to moderate PD [46].…”