Background: Turning is a common trigger for freezing episodes in patients with Parkinson's disease (PD). Freezing during turning can lead to falls and fractures and decreased quality of life.
Research Question: Does foot-strike contact variability also increase during turning, as previously reported in straight gait in PD patients with Freezing of Gait (FOG)?
Methods: Subjects were instructed to walk on a gait mat, making "normal pivot" (180°) turns at each end. ProtoKinetics Movement Analysis Software (PKMAS) software was used for analysis. Video recordings and foot-pressure-prints were studied to identify and define turn segments. Spatiotemporal gait and turn measures were then determined only for the turn segments. A movement disorders neurologist determined clinical freezes.
Results: 100 subjects (28 controls, 38 noFOG and 34 FOG) were included. Compared to non-freezers (noFOG), FOG subjects had a smaller foot-strike during turning (a measure of completeness of foot contact with the mat) and increased foot-strike variability. FOG subjects also had a shorter stride-length, slower stride-velocity, and greater swing phase time and percentage during turns. After adjusting for turn direction, inner/outer leg dynamics showed heavier inner leg footsteps in FOG subjects. 38% of FOG subjects experienced freezes during turning. 69% of freezes occurred during the middle third of the turn. Turn-freezers had more severe spatiotemporal gait deficits.
Significance: Developing targeted therapies to retrain subjects to plant their whole foot on the ground with more consistency could help decrease episodes of freezing of gait.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109154 | PMC |
| http://dx.doi.org/10.1016/j.gaitpost.2021.12.012 | DOI Listing |
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