Increased foot strike variability during turning in Parkinson's disease patients with freezing of gait.
Lakshmi Pillai, Kunal Shah, Aliyah Glover and 1 others
PMID 34915403WHAT IT FOUND
People with Parkinson's who freeze take shorter, wider turns with less foot contact and more variability.
Freezing happens most often in the middle of a turn, where the body must change direction fastest, suggesting this phase is a key target for therapy.
Key findings
01Subjects with freezing of gait had significantly shorter foot contact with the ground and increased foot-strike variability during turns compared to those without freezing.
02The majority of witnessed freezing episodes occurred during the middle third of the turn, coinciding with maximal angular changes.
03Freezing was more prevalent on the outer leg than the inner leg during turning tasks.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was conducted in a controlled laboratory setting, which may not fully replicate the distractions and terrain of real-world community walking. Participants were assessed in their usual levodopa-medicated state, so the findings may differ for patients experiencing motor fluctuations or 'off' periods. The group with freezing of gait had more severe disease characteristics (higher UPDRS scores, longer duration) than the group without freezing, which may confound some comparisons.
Declared interests
The authors declared no conflicts of interest. The study was supported by NIH grants and non-U.S. government research support.
The easy way to misread this
Do not assume these findings apply to patients in their 'off' medication state or during complex dual-task walking, as this study measured single-task turning in medicated individuals. The association between gait features and freezing does not prove that changing these features will prevent freezing.