Freezing of gait in Parkinson's disease: the impact of dual-tasking and turning

Movement Disorders : Official Journal of the Movement Disorder Society
Joke SpildoorenAlice Nieuwboer

Abstract

Turning is the most important trigger for freezing of gait (FOG) in Parkinson's disease (PD), and dual-tasking has been suggested to influence FOG as well. To understand the effects of dual tasking and turning on FOG. 14 Freezers and 14 non-freezers matched for disease severity and 14 age-matched controls were asked to turn 180° and 360° with and without a cognitive dual-task during the off-period of the medication cycle. Total number of steps, duration, cadence, freezing-frequency, and secondary-task performance were measured. Seven freezers froze during the protocol. Freezing occurred in 37.5% of trials during 180° turning compared to 0% during straight-line walking (X(2) = 10.44, p < 0.01). The occurrence of FOG increased during 360° when also a dual-task was added (X(2) = 4.23, p = 0.04). Freezers took significantly more steps and were slower than controls in all conditions. The presence of a dual-task increased these differences. Cadence increased significantly for freezers during 360° and 180° compared to straight-line walking. In contrast, cadence was decreased during turning in controls and non-freezers. During straight-line walking, only freezers made errors in the secondary task. Controls increased their error-rate du...Continue Reading

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