Publication year
2012Source
Parkinsonism & Related Disorders, 18, 2, (2012), pp. 149-54ISSN
Annotation
01 februari 2012
Publication type
Article / Letter to editor

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Organization
Neurology
Donders Centre for Cognitive Neuroimaging
IQ Healthcare
Former Organization
F.C. Donders Centre for Cognitive Neuroimaging
Journal title
Parkinsonism & Related Disorders
Volume
vol. 18
Issue
iss. 2
Page start
p. 149
Page end
p. 54
Subject
111 000 Intention & Action; DCN 2: Functional Neurogenomics NCEBP 10: Human Movement & Fatigue; DCN MP - Plasticity and memory; DCN MP - Plasticity and memory NCEBP 10: Human Movement & Fatigue; DCN MP - Plasticity and memory NCEBP 4 - Quality of hospital and integrated care; NCEBP 6: Quality of nursing and allied health care; NCEBP 6: Quality of nursing and allied health careAbstract
INTRODUCTION: Freezing of gait (FOG) is both common and debilitating in patients with Parkinson's disease (PD). Future pathophysiology studies will depend critically upon adequate classification of patients as being either 'freezers' or 'non-freezers'. This classification should be based ideally upon objective confirmation by an experienced observer during clinical assessment. Given the known difficulties to elicit FOG when examining patients, we aimed to investigate which simple clinical test would be the most sensitive to provoke FOG objectively. METHODS: We examined 50 patients with PD, including 32 off-state freezers (defined as experiencing subjective 'gluing of the feet to the floor'). Assessment including a FOG trajectory (three trials: normal speed, fast speed, and with dual tasking) and several turning variants (180 degrees vs. 360 degrees turns; leftward vs. rightward turns; wide vs. narrow turning; and slow vs. fast turns). RESULTS: Sensitivity of the entire assessment to provoke FOG in subjective freezers was 0.74, specificity was 0.94. The most effective test to provoke FOG was rapid 360 degrees turns in both directions and, if negative, combined with a gait trajectory with dual tasking. Repeated testing improved the diagnostic yield. The least informative tests included wide turns, 180 degrees turns or normal speed full turns. Sensitivity to provoke objective FOG in subjective freezers was 0.65 for the rapid full turns in both directions and 0.63 for the FOG trajectory. DISCUSSION: The most efficient way to objectively ascertain FOG is asking patients to repeatedly make rapid 360 degrees narrow turns from standstill, on the spot and in both directions.
This item appears in the following Collection(s)
- Academic publications [202923]
- Donders Centre for Cognitive Neuroimaging [3357]
- Faculty of Medical Sciences [80072]
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