Trina Mitchell1, David Conradsson2, Caroline Paquette3. 1. Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. 2. Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada; Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden. 3. Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Electronic address: caroline.paquette@mcgill.ca.
Abstract
INTRODUCTION: Although turning during walking is known to trigger freezing of gait (FOG) in Parkinson's disease (PD), little is known about kinematic strategies used by individuals with PD and FOG while performing prolonged turning. OBJECTIVE: Our aim was to compare gait and trunk kinematics during straight walking and continuous turning over 20-min in PD with and without FOG. METHODS: 18 individuals with idiopathic PD (n = 9 with FOG, n = 9 without FOG), performed two 20-min walking tasks: straight ahead, and turning, in a laboratory setting in their OFF medication state. Accelerometer-based spatial and temporal gait parameters and trunk kinematics (range of motion, peak velocity, variability of range of motion and peak velocity) were analyzed. RESULTS: During turning, PD with FOG reduced cadence more compared to PD without FOG (P <0.045), despite similar decline in stride velocity (28-32%) and stride length (24-27%). Participants with FOG had decreased variability of gait speed (P <0.011), stride length (P <0.035), frontal trunk range of motion (P <0.040) and peak trunk velocity (P <0.017) compared to PD without FOG during turning, whereas there was no difference between groups during straight walking. Gait speed variability and cadence between these two tasks differentiated the PD groups (sensitivity 89% and specificity 78%). CONCLUSIONS: We demonstrate that PD with FOG decreased cadence and reduced variability of walking speed, stride length, and lateral flexion of the trunk compared to PD without FOG during prolonged turning. These real-life gait markers are observable during lab-based gait that is similar to daily-life.
INTRODUCTION: Although turning during walking is known to trigger freezing of gait (FOG) in Parkinson's disease (PD), little is known about kinematic strategies used by individuals with PD and FOG while performing prolonged turning. OBJECTIVE: Our aim was to compare gait and trunk kinematics during straight walking and continuous turning over 20-min in PD with and without FOG. METHODS: 18 individuals with idiopathic PD (n = 9 with FOG, n = 9 without FOG), performed two 20-min walking tasks: straight ahead, and turning, in a laboratory setting in their OFF medication state. Accelerometer-based spatial and temporal gait parameters and trunk kinematics (range of motion, peak velocity, variability of range of motion and peak velocity) were analyzed. RESULTS: During turning, PD with FOG reduced cadence more compared to PD without FOG (P <0.045), despite similar decline in stride velocity (28-32%) and stride length (24-27%). Participants with FOG had decreased variability of gait speed (P <0.011), stride length (P <0.035), frontal trunk range of motion (P <0.040) and peak trunk velocity (P <0.017) compared to PD without FOG during turning, whereas there was no difference between groups during straight walking. Gait speed variability and cadence between these two tasks differentiated the PD groups (sensitivity 89% and specificity 78%). CONCLUSIONS: We demonstrate that PD with FOG decreased cadence and reduced variability of walking speed, stride length, and lateral flexion of the trunk compared to PD without FOG during prolonged turning. These real-life gait markers are observable during lab-based gait that is similar to daily-life.
Authors: Mikaela L Frechette; Brett M Meyer; Lindsey J Tulipani; Reed D Gurchiek; Ryan S McGinnis; Jacob J Sosnoff Journal: Curr Neurol Neurosci Rep Date: 2019-09-04 Impact factor: 5.081
Authors: Sabine Janssen; Jaap de Ruyter van Steveninck; Hizirwan S Salim; Helena M Cockx; Bastiaan R Bloem; Tjitske Heida; Richard J A van Wezel Journal: Front Neurol Date: 2020-03-24 Impact factor: 4.003