Characteristics associated with freezing of gait in actual daily living in Parkinson's disease.
Mitsuaki Ishii, Kohei Okuyama
PMID 29643593WHAT IT FOUND
Parkinson's patients with freezing of gait reported episodes most often when fatigued (89.3%), and when hurrying to the toilet, in crowded places, or answering the phone.
Fatigue was frequent but did not match other situational patterns.
Key findings
01Fatigue was the most frequent trigger (89.3%), and more than 70% reported freezing when hurrying to the toilet, in crowded places, or answering a telephone or doorbell.
02The first main pattern included unfamiliar places, unpredictable schedule changes, entering an elevator or automatic door, another person suddenly crossing in front, and change in the walking surface; fatigue was not associated with any pattern.
03The four groups created by the clustering method differed in PDQ-39 mobility scores (p=0.002), and group 4 had the lowest score (5.13).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only 28 Parkinson's disease patients who already had freezing of gait, so it cannot show how common these patterns are in all Parkinson's disease patients. It relied on self-reported episodes in 14 situations, so it reports associations and patterns, not causes or treatment effects. The authors state that the sample size was small and that the concept behind the first component was broad. They call for further study. All participants had freezing severity above the study's inclusion thresholds, so it may not describe patients below those thresholds. The grouping and cluster methods were exploratory, and the paper does not explain how to interpret the PDQ-39 mobility score direction.
Declared interests
The authors declared no relevant conflicts of interest and no external funding.
The easy way to misread this
Do not conclude that fatigue causes freezing of gait or that treating fatigue will reduce freezing. The study reports self-reported trigger frequencies and statistical patterns, and it did not test any treatment.