Gait festination and freezing in Parkinson's disease: Pathogenesis and rehabilitation

Morris, Meg E.; Iansek, Robert; Galna, Brook

doi:10.1002/mds.21974

Cited by 89 publications

(66 citation statements)

References 49 publications

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“…The vertical force traces showed that subjects were alternatively loading/unloading the legs but were unable to completely lift the feet off the ground. This phenomenon has been referred to as an underscaled bodyweight transfer [24][25][26] and has been observed during video analyses of trials in PD subjects walking with foot insoles and in the vertical accelerations of the shank [2,8,27]. It has been reported that these episodes present a complex motor pattern with higher frequency components than normal walking [8,27].…”

Section: Underscaled Repetitive Alternating Stepping May Provide Insimentioning

confidence: 97%

Repetitive stepping in place identifies and measures freezing episodes in subjects with Parkinson's disease

2011

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Section: Underscaled Repetitive Alternating Stepping May Provide Insimentioning

confidence: 97%

Repetitive stepping in place identifies and measures freezing episodes in subjects with Parkinson's disease

2011

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“…These gait problems include reduced or absent arm swing, shuffling steps, reduced stride length leading to an overall reduction in walking velocity [26,31], slower turning [54], balance problems [7], festination (an accelerating series of short steps while leaning forwards) [32], and freezing of gait (FoG) during which effective walking ceases temporarily and the patient feels as if their feet are 'glued to the floor' [15][16][17]. These gait problems in PD increase the risk of falls and the associated fear of falling (FoF) can influence daily activities, especially those that involve venturing outside the home [41].…”

Section: Introductionmentioning

confidence: 99%

The effect of real and virtual visual cues on walking in Parkinson’s disease

et al. 2011

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Patients with Parkinson's disease (PwPD) have a slow, shuffling gait, marked by sporadic freezing of gait (FoG) during which effective stepping ceases temporarily. As these gait problems are not commonly improved by medical and surgical treatments, alternative approaches to manage these problems have been adopted. The aim of this study was to evaluate the effect of real and virtual visual cues on walking in PD. We assessed 26 mid-stage PwPD, on and off medication, on a laboratory-based walking task which simulated real world challenges by incorporating FoG triggers and using appropriate placebo conditions. Cueing interventions were presented via virtual reality glasses (VRG rhythmic, visual flow and static placebo cues), and as transverse lines (TL) on the walkway. Objective measures of gait (task completion time; velocity, cadence, stride length; FoG frequency) and self-rated fear of falling (FoF) were recorded. Cueing intervention affected task completion time only off medication. Whereas placebo VRG cues provided no improvement in walking, visual flow VRG cues marginally reduced the task completion time. TL on the floor elicited more substantial improvements in gait with reduced cadence, increased stride length and reduced FoG frequency. VRG rhythmic cueing impaired overall walking. Notably, a final no-intervention condition yielded quicker task completion, greater walking velocity, increased stride length and less frequent FoG. Although the VRG produced modest improvements only in the visual flow condition, their flexibility is an advantage. These results endorse the use of TL and justify further testing and customisation of VRG cues for individual PwPD.

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“…Further supporting the role of diverse and nondopaminergic circuitry in the mechanism of FOG, visual and auditory cueing strategies have been reported to ameliorate FOG and other gait deficits in patients with PD [8][9][10][11][12]. High-contrast, transverse line visual cues on the floor have been found to improve stride length and velocity, among other measures, in patients with PD in several trials, one of which also demonstrated reduced FOG episodes [11,[13][14][15][16][17][18].…”

Section: Freezing Of Gait (Fog) Is a Disabling Phenomenon That Affectmentioning

confidence: 97%

Laser light visual cueing for freezing of gait in Parkinson disease:A pilot study with male participants

Bunting-Perry¹,

Spindler²,

Robinson³

et al. 2013

JRRD

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Abstract-Freezing of gait (FOG) is a debilitating feature of Parkinson disease (PD).In this pilot study, we sought to assess the efficacy of a rolling walker with a laser beam visual cue to treat FOG in PD patients. We recruited 22 subjects with idiopathic PD who experienced on-and off-medication FOG. Subjects performed three walking tasks both with and without the laser beam while on medications. Outcome measures included time to complete tasks, number of steps, and number of FOG episodes. A crossover design allowed within-group comparisons between the two conditions. No significant differences were observed between the two walking conditions across the three tasks. The laser beam, when applied as a visual cue on a rolling walker, did not diminish FOG in this study.

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Gait festination and freezing in Parkinson's disease: Pathogenesis and rehabilitation

Cited by 89 publications

References 49 publications

Repetitive stepping in place identifies and measures freezing episodes in subjects with Parkinson's disease

Repetitive stepping in place identifies and measures freezing episodes in subjects with Parkinson's disease

The effect of real and virtual visual cues on walking in Parkinson’s disease

Laser light visual cueing for freezing of gait in Parkinson disease:A pilot study with male participants

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