Duration of step initiation predicts freezing in Parkinson's disease

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4 Citations (Scopus)

Abstract

Objectives: In some individuals with idiopathic Parkinson's disease (PD), freezing of gait episodes develops as the disease progresses. The neural mechanism underlying freezing in PD is poorly understood. Here, we report a 2-year follow-up on the novel discovery of prolonged step initiation duration as a potential marker of impending freezing. Methods: Non-freezing PD participants in stages 2.5-4 of the Hoehn and Yahr disease severity scale were recruited from an earlier study which determined the effect of semi-virtual cues on walking. Responders were those who completed the first step faster in the presence of the virtual cues while non-responders either did not change or took longer to complete the first step. Both groups of participants were interviewed 2 years later to determine who had developed freezing of gait. Results: Participants in the responder group had a 13-fold risk of developing freezing of gait within 2 years following the cueing study (OR = 13.3, 95% CI = 1.1-167). A cutoff score of -2.6% (i.e., a decrease in the duration of the first step with visual cues by 2.6% relative to no cues) gave a sensitivity and specificity of 100% and 89%, respectively. Conclusions: To the best of our knowledge, this is the first novel discovery of a physical predictor of freezing in PD. The time to complete the first step is a simple test to administer in the clinic or at home and may therefore be easily incorporated into a fall prevention training program for PD before the inception of freezing.

Original languageEnglish (US)
Pages (from-to)105-110
Number of pages6
JournalActa Neurologica Scandinavica
Volume132
Issue number2
DOIs
StatePublished - Aug 1 2015

Fingerprint

Freezing
Parkinson Disease
Cues
Gait
Walking
Education
Sensitivity and Specificity

Keywords

  • falls
  • fear of falling
  • gait
  • questionnaire
  • walking

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

@article{83afa342cbb14b4eb93b0d8e41f9d076,
title = "Duration of step initiation predicts freezing in Parkinson's disease",
abstract = "Objectives: In some individuals with idiopathic Parkinson's disease (PD), freezing of gait episodes develops as the disease progresses. The neural mechanism underlying freezing in PD is poorly understood. Here, we report a 2-year follow-up on the novel discovery of prolonged step initiation duration as a potential marker of impending freezing. Methods: Non-freezing PD participants in stages 2.5-4 of the Hoehn and Yahr disease severity scale were recruited from an earlier study which determined the effect of semi-virtual cues on walking. Responders were those who completed the first step faster in the presence of the virtual cues while non-responders either did not change or took longer to complete the first step. Both groups of participants were interviewed 2 years later to determine who had developed freezing of gait. Results: Participants in the responder group had a 13-fold risk of developing freezing of gait within 2 years following the cueing study (OR = 13.3, 95{\%} CI = 1.1-167). A cutoff score of -2.6{\%} (i.e., a decrease in the duration of the first step with visual cues by 2.6{\%} relative to no cues) gave a sensitivity and specificity of 100{\%} and 89{\%}, respectively. Conclusions: To the best of our knowledge, this is the first novel discovery of a physical predictor of freezing in PD. The time to complete the first step is a simple test to administer in the clinic or at home and may therefore be easily incorporated into a fall prevention training program for PD before the inception of freezing.",
keywords = "falls, fear of falling, gait, questionnaire, walking",
author = "Chong, {Kwong Yew Raymond} and Lee, {K. H.} and Morgan, {John Christopher} and Wakade, {Chandramohan G.}",
year = "2015",
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T1 - Duration of step initiation predicts freezing in Parkinson's disease

AU - Chong, Kwong Yew Raymond

AU - Lee, K. H.

AU - Morgan, John Christopher

AU - Wakade, Chandramohan G.

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N2 - Objectives: In some individuals with idiopathic Parkinson's disease (PD), freezing of gait episodes develops as the disease progresses. The neural mechanism underlying freezing in PD is poorly understood. Here, we report a 2-year follow-up on the novel discovery of prolonged step initiation duration as a potential marker of impending freezing. Methods: Non-freezing PD participants in stages 2.5-4 of the Hoehn and Yahr disease severity scale were recruited from an earlier study which determined the effect of semi-virtual cues on walking. Responders were those who completed the first step faster in the presence of the virtual cues while non-responders either did not change or took longer to complete the first step. Both groups of participants were interviewed 2 years later to determine who had developed freezing of gait. Results: Participants in the responder group had a 13-fold risk of developing freezing of gait within 2 years following the cueing study (OR = 13.3, 95% CI = 1.1-167). A cutoff score of -2.6% (i.e., a decrease in the duration of the first step with visual cues by 2.6% relative to no cues) gave a sensitivity and specificity of 100% and 89%, respectively. Conclusions: To the best of our knowledge, this is the first novel discovery of a physical predictor of freezing in PD. The time to complete the first step is a simple test to administer in the clinic or at home and may therefore be easily incorporated into a fall prevention training program for PD before the inception of freezing.

AB - Objectives: In some individuals with idiopathic Parkinson's disease (PD), freezing of gait episodes develops as the disease progresses. The neural mechanism underlying freezing in PD is poorly understood. Here, we report a 2-year follow-up on the novel discovery of prolonged step initiation duration as a potential marker of impending freezing. Methods: Non-freezing PD participants in stages 2.5-4 of the Hoehn and Yahr disease severity scale were recruited from an earlier study which determined the effect of semi-virtual cues on walking. Responders were those who completed the first step faster in the presence of the virtual cues while non-responders either did not change or took longer to complete the first step. Both groups of participants were interviewed 2 years later to determine who had developed freezing of gait. Results: Participants in the responder group had a 13-fold risk of developing freezing of gait within 2 years following the cueing study (OR = 13.3, 95% CI = 1.1-167). A cutoff score of -2.6% (i.e., a decrease in the duration of the first step with visual cues by 2.6% relative to no cues) gave a sensitivity and specificity of 100% and 89%, respectively. Conclusions: To the best of our knowledge, this is the first novel discovery of a physical predictor of freezing in PD. The time to complete the first step is a simple test to administer in the clinic or at home and may therefore be easily incorporated into a fall prevention training program for PD before the inception of freezing.

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