Additional weight load increases freezing of gait episodes in Parkinson’s disease; an experimental study

Freezing of gait is an episodic gait disorder, characterized by the inability to generate effective forward stepping movements. The pathophysiology underlying freezing of gait remains insufficiently understood, and this hampers the development of better treatment strategies. Preliminary evidence sug...

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Bibliographic Details
Published in:Journal of neurology 2014-05, Vol.261 (5), p.999-1008
Main Authors: Mensink, Senja H. G., Nonnekes, Jorik, van Bon, Geert, Snijders, Anke H., Duysens, Jacques, Weerdesteyn, Vivian, Bloem, Bastiaan R., Oude Nijhuis, Lars B.
Format: Article
Language:English
Subjects:
Aged
Female
Gait
Gait Disorders, Neurologic - diagnosis
Gait Disorders, Neurologic - physiopathology
Humans
Kinematics
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Neuroradiology
Neurosciences
Original Communication
Parkinson Disease - diagnosis
Parkinson Disease - physiopathology
Parkinson's disease
Pathophysiology
Pilot Projects
Posture
Questionnaires
Weight-Bearing - physiology
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Summary:Freezing of gait is an episodic gait disorder, characterized by the inability to generate effective forward stepping movements. The pathophysiology underlying freezing of gait remains insufficiently understood, and this hampers the development of better treatment strategies. Preliminary evidence suggests that impaired force control during walking may contribute to freezing episodes, with difficulty to unload the swing leg and initiate the swing phase. Here, we used external loading to manipulate force control and to investigate its influence on freezing of gait. Twelve Parkinson’s disease patients with freezing of gait performed three contrasting tasks: (1) loaded gait while wearing a belt fortified with lead weights; (2) weight-supported gait using a parachute harness connected to a rigid metal cable running above the gait trajectory; and (3) normal gait. Gait tasks were used to provoke freezing episodes, including rapid 360° turns. Freezing episodes were quantified using blinded, videotaped clinical assessment. Furthermore, ground reaction forces and body kinematics were recorded. Loading significantly increased the mean number of freezing episodes per trial compared to the normal gait condition ( P  
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-014-7274-2