Obstacle avoidance to elicit freezing of gait during treadmill walking
Identifieur interne : 001B43 ( Main/Exploration ); précédent : 001B42; suivant : 001B44Obstacle avoidance to elicit freezing of gait during treadmill walking
Auteurs : Anke H. Snijders [Pays-Bas] ; Vivian Weerdesteyn [Pays-Bas] ; Yolien J. Hagen [Pays-Bas] ; Jacques Duysens [Pays-Bas] ; Nir Giladi [Israël] ; Bastiaan R. Bloem [Pays-Bas]Source :
- Movement Disorders [ 0885-3185 ] ; 2010-01-15.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Congélation.
English descriptors
- KwdEn :
- Adult, Aged, Avoidance, Exercise Test (methods), Female, Freezing, Freezing Reaction, Cataleptic (physiology), Gait Disorders, Neurologic (diagnosis), Gait Disorders, Neurologic (etiology), Gait disorder, Humans, Male, Middle Aged, Nervous system diseases, Outcome Assessment (Health Care) (methods), Parkinson Disease (complications), Parkinson disease, Parkinson's disease, Statistics, Nonparametric, Video Recording (methods), Walking, Walking (physiology), freezing of gait, gait disorders, obstacle avoidance.
- MESH :
- complications : Parkinson Disease.
- diagnosis : Gait Disorders, Neurologic.
- etiology : Gait Disorders, Neurologic.
- methods : Exercise Test, Outcome Assessment (Health Care), Video Recording.
- physiology : Freezing Reaction, Cataleptic, Walking.
- Adult, Aged, Female, Humans, Male, Middle Aged, Statistics, Nonparametric.
Abstract
Freezing of gait (FOG) is a common and disabling feature of Parkinson's disease (PD). Detailed pathophysiological studies are hampered by the fact that FOG episodes are difficult to elicit in a gait laboratory. We evaluated whether the need to avoid sudden obstacles on a treadmill can provoke FOG. We included 21 PD patients (15 with self‐reported off‐period FOG). Patients were tested in the off‐state. FOG during overground walking was assessed using a standardized gait trajectory and axial 360° turns. Subsequently, patients walked on a motorized treadmill with suddenly appearing obstacles that necessitated compensatory stepping. Performance was videotaped, and presence of FOG was scored visually by two independent raters. Thirteen patients showed FOG during overground walking. During treadmill walking, obstacle avoidance was associated with 13 unequivocal FOG episodes in eight patients, whereas only one patient froze during undisturbed treadmill walking (Wilcoxon z = −2.0, P = 0.046). FOG episodes elicited by obstacle avoidance were brief (typically <1 s). Almost all episodes were provoked when subjects had a longer available response time. In conclusion, suddenly appearing obstacles on a treadmill can elicit FOG in a controlled laboratory setting. However, the moving treadmill and the obstacle both act as cues, which apparently help to immediately overcome the provoked FOG episode. This may limit the ecological validity of this new approach. © 2009 Movement Disorder Society
Url:
DOI: 10.1002/mds.22894
Affiliations:
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Le document en format XML
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<front><div type="abstract" xml:lang="en">Freezing of gait (FOG) is a common and disabling feature of Parkinson's disease (PD). Detailed pathophysiological studies are hampered by the fact that FOG episodes are difficult to elicit in a gait laboratory. We evaluated whether the need to avoid sudden obstacles on a treadmill can provoke FOG. We included 21 PD patients (15 with self‐reported off‐period FOG). Patients were tested in the off‐state. FOG during overground walking was assessed using a standardized gait trajectory and axial 360° turns. Subsequently, patients walked on a motorized treadmill with suddenly appearing obstacles that necessitated compensatory stepping. Performance was videotaped, and presence of FOG was scored visually by two independent raters. Thirteen patients showed FOG during overground walking. During treadmill walking, obstacle avoidance was associated with 13 unequivocal FOG episodes in eight patients, whereas only one patient froze during undisturbed treadmill walking (Wilcoxon z = −2.0, P = 0.046). FOG episodes elicited by obstacle avoidance were brief (typically <1 s). Almost all episodes were provoked when subjects had a longer available response time. In conclusion, suddenly appearing obstacles on a treadmill can elicit FOG in a controlled laboratory setting. However, the moving treadmill and the obstacle both act as cues, which apparently help to immediately overcome the provoked FOG episode. This may limit the ecological validity of this new approach. © 2009 Movement Disorder Society</div>
</front>
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