Christian Schlenstedt1, Muthuraman Muthuraman2, Karsten Witt2, Burkhard Weisser3, Alfonso Fasano4, Günther Deuschl5. 1. Department of Neurology, Christian-Albrechts-University, Kiel, Germany; Department of Sport Science, Christian-Albrechts-University, Kiel, Germany. 2. Department of Neurology, Christian-Albrechts-University, Kiel, Germany. 3. Department of Sport Science, Christian-Albrechts-University, Kiel, Germany. 4. Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital - UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada. 5. Department of Neurology, Christian-Albrechts-University, Kiel, Germany. Electronic address: g.deuschl@neurologie.uni-kiel.de.
Abstract
INTRODUCTION: The relationship between freezing of gait (FOG) and postural instability in Parkinson's disease (PD) is unclear. We analyzed the impact of FOG on postural control. METHODS: 31 PD patients with FOG (PD+FOG), 27 PD patients without FOG (PD-FOG) and 22 healthy control (HC) were assessed in the ON state. Postural control was measured with the Fullerton Advanced Balance (FAB) scale and with center of pressure (COP) analysis during quiet stance and maximal voluntary forward/backward leaning. RESULTS: The groups were balanced concerning age, disease duration and disease severity. PD+FOG performed significantly worse in the FAB scale (21.8 ± 5.8) compared to PD-FOG (25.6 ± 5.0) and HC (34.9 ± 2.4) (mean ± SD, p < 0.01). PD+FOG had impaired ability to voluntary lean forward, difficulties to stand on foam with eyes closed and reduced limits of stability compared to PD-FOG (p < 0.05). During quiet stance the average anterior-posterior COP position was significantly displaced towards posterior in PD+FOG in comparison to PD-FOG and HC (p < 0.05). The COP position correlated with severity of FOG (p < 0.01). PD+FOG and PD-FOG did not differ in average COP sway excursion, sway velocity, sway regularity and postural control asymmetry. CONCLUSIONS: PD+FOG have reduced postural control compared to PD-FOG and HC. Our results show a relationship between the anterior-posterior COP position during quiet stance and FOG. The COP shift towards posterior in PD+FOG leads to a restricted precondition to generate forward progression during gait initiation. This may contribute to the occurrence of FOG or might be a compensatory strategy to avoid forward falls.
INTRODUCTION: The relationship between freezing of gait (FOG) and postural instability in Parkinson's disease (PD) is unclear. We analyzed the impact of FOG on postural control. METHODS: 31 PD patients with FOG (PD+FOG), 27 PD patients without FOG (PD-FOG) and 22 healthy control (HC) were assessed in the ON state. Postural control was measured with the Fullerton Advanced Balance (FAB) scale and with center of pressure (COP) analysis during quiet stance and maximal voluntary forward/backward leaning. RESULTS: The groups were balanced concerning age, disease duration and disease severity. PD+FOG performed significantly worse in the FAB scale (21.8 ± 5.8) compared to PD-FOG (25.6 ± 5.0) and HC (34.9 ± 2.4) (mean ± SD, p < 0.01). PD+FOG had impaired ability to voluntary lean forward, difficulties to stand on foam with eyes closed and reduced limits of stability compared to PD-FOG (p < 0.05). During quiet stance the average anterior-posterior COP position was significantly displaced towards posterior in PD+FOG in comparison to PD-FOG and HC (p < 0.05). The COP position correlated with severity of FOG (p < 0.01). PD+FOG and PD-FOG did not differ in average COP sway excursion, sway velocity, sway regularity and postural control asymmetry. CONCLUSIONS:PD+FOG have reduced postural control compared to PD-FOG and HC. Our results show a relationship between the anterior-posterior COP position during quiet stance and FOG. The COP shift towards posterior in PD+FOG leads to a restricted precondition to generate forward progression during gait initiation. This may contribute to the occurrence of FOG or might be a compensatory strategy to avoid forward falls.
Authors: Kévin Ahrweiller; J F Houvenaghel; A Riou; S Drapier; P Sauleau; C Haegelen; P Jannin; M Vérin; X Palard; F Le Jeune Journal: J Neurol Date: 2019-07-26 Impact factor: 4.849
Authors: Ana Claudia de Souza Fortaleza; Martina Mancini; Patty Carlson-Kuhta; Laurie A King; John G Nutt; Eliane Ferrari Chagas; Ismael Forte Freitas; Fay B Horak Journal: Gait Posture Date: 2017-05-10 Impact factor: 2.840
Authors: Paul Lennart Vollmers; Christoph Mundhenke; Nicolai Maass; Dirk Bauerschlag; Stefan Kratzenstein; Christoph Röcken; Thorsten Schmidt Journal: J Cancer Res Clin Oncol Date: 2018-06-25 Impact factor: 4.553
Authors: Catherine Quatman-Yates; Scott Bonnette; Resmi Gupta; Jason A Hugentobler; Shari L Wade; Tracy A Glauser; Richard F Ittenbach; Mark V Paterno; Michael A Riley Journal: Hum Mov Sci Date: 2018-02-10 Impact factor: 2.161
Authors: Ellen N Sutter; Katie J Seidler; Ryan P Duncan; Gammon M Earhart; Marie E McNeely Journal: J Rehabil Med Date: 2017-06-28 Impact factor: 2.912
Authors: Gianluca Bonora; Martina Mancini; Ilaria Carpinella; Lorenzo Chiari; Maurizio Ferrarin; John G Nutt; Fay B Horak Journal: Front Neurol Date: 2017-07-25 Impact factor: 4.003