Journal of neuroengineering and rehabilitation

1743-00031712020Oct31Journal of neuroengineering and rehabilitationJ Neuroeng Rehabil'Recoupling' the attentional and motor control of preparatory postural adjustments to overcome freezing of gait in Parkinson's.14614614610.1186/s12984-020-00776-1This study examined if people with Parkinson's and freezing of gait pathology (FoG) could be trained to increase preparatory weight-shift amplitude, and facilitate step initiation during FoG.Thirty-five people with Parkinson's and FoG attempted to initiate forward walking from a stationary position caused by a freeze (n = 17, FoG-F) or voluntarily stop (n = 18, FoG-NF) in a Baseline condition and two conditions where an increased weight-shift amplitude was trained via: (i) explicit verbal instruction, and (ii) implicit movement analogies.At Baseline, weight-shift amplitudes were smaller during: (i) unsuccessful, compared to successful step initiations (FoG-F group), and (ii) successful step initiations in the FoG-F group compared to FoG-NF. Both Verbal and Analogy training resulted in significant increases in weight-shift amplitude in both groups, and a corresponding pronounced reduction in unsuccessful attempts to initiate stepping (FoG-F group).Hypometric preparatory weight-shifting is associated with failure to initiate forward stepping in people with Parkinson's and FoG. However, impaired weight-shift characteristics are modifiable through conscious strategies. This current study provides a novel and critical evaluation of preparatory weight-shift amplitudes during FoG events. The intervention described represents an attractive 'rescue' strategy and should be further scrutinised regarding limitations posed by physical and cognitive deficits.MaslivecAmyADepartment of Surgery and Cancer, Imperial College London, London, UK.FieldingAnnaACollege of Health and Life Sciences, Brunel University London, Uxbridge, UK.WilsonMarkMSchool of Sport and Health Sciences, University of Exeter, Exeter, EX1 2LU, UK.NorrisMerielMCollege of Health and Life Sciences, Brunel University London, Uxbridge, UK.YoungWilliamW0000-0002-5064-8601College of Health and Life Sciences, Brunel University London, Uxbridge, UK. w.young@exeter.ac.uk.School of Sport and Health Sciences, University of Exeter, Exeter, EX1 2LU, UK. w.young@exeter.ac.uk.engClinical TrialJournal ArticleResearch Support, Non-U.S. Gov't20201031