The Ziegler Test Is Reliable and Valid for Measuring Freezing of Gait in People With Parkinson Disease.
Lina Goh, Serene S Paul, Colleen G Canning and 4 others
PMID 36130220WHAT IT FOUND
The Ziegler test total score showed good agreement among physical therapists and excellent agreement when the same raters rescored them later.
Scores and duration correlated with percentage of time spent frozen. Use the total score, not individual start, turn, or doorway ratings.
Key findings
01The total Ziegler test score had good agreement between raters (ICC 0.80).
02The total Ziegler test score had excellent agreement when the same raters rescored the videos at least 1 week later (ICC 0.91).
03The total Ziegler test score correlated with percentage of time spent frozen (r 0.72).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 10 people with Parkinson disease and freezing of gait provided the videos, and only 1 was female, so the results may not apply to all patients. Physical therapists rated compressed videos remotely rather than in person, and 10% of videos were viewed more than once because of technical issues, so clinic ratings may differ. The start and doorway situations were not defined clearly enough, and therapists interpreted them differently, which lowered reliability for individual situations. The rating scale does not capture how often freezing occurs or how long episodes last, so it may underestimate severity in people with many or long episodes. Test-retest reliability was based on only two researchers, and the study did not show that the test can detect change in freezing over time.
Declared interests
The Australian Government Research Training Program Scholarship funded the study, and the funders played no role in design, conduct, or reporting.
The easy way to misread this
Do not use individual start, turn, or doorway scores as separate reliable measures. Therapists interpreted those situations differently, and agreement between raters was only moderate for those individual situations.