Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment
Several gait impairments have been associated with freezing of gait (FOG) in patients with Parkinson's disease (PD). These include deteriorations in rhythm control, gait symmetry, bilateral coordination of gait, dynamic postural control and step scaling. We suggest that these seemingly independ...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Parkinson's Disease |
| Online Access: | http://dx.doi.org/10.1155/2012/459321 |
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| _version_ | 1832548744885698560 |
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| author | Meir Plotnik Nir Giladi Jeffrey M. Hausdorff |
| author_facet | Meir Plotnik Nir Giladi Jeffrey M. Hausdorff |
| author_sort | Meir Plotnik |
| collection | DOAJ |
| description | Several gait impairments have been associated with freezing of gait (FOG) in patients with Parkinson's disease (PD). These include deteriorations in rhythm control, gait symmetry, bilateral coordination of gait, dynamic postural control and step scaling. We suggest that these seemingly independent gait features may have mutual interactions which, during certain circumstances, jointly drive the predisposed locomotion system into a FOG episode. This new theoretical framework is illustrated by the evaluation of the potential relationships between the so-called “sequence effect”, that is, impairments in step scaling, and gait asymmetry just prior to FOG. We further discuss what factors influence gait control to maintain functional gait. “Triggers”, for example, such as attention shifts or trajectory transitions, may precede FOG. We propose distinct categories of interventions and describe examples of existing work that support this idea: (a) interventions which aim to maintain a good level of locomotion control especially with respect to aspects related to FOG; (b) those that aim at avoiding FOG “triggers”; and (c) those that merely aim to escape from FOG once it occurs. The proposed theoretical framework sets the stage for testable hypotheses regarding the mechanisms that lead to FOG and may also lead to new treatment ideas. |
| format | Article |
| id | doaj-art-f6cfbc83dfe944958088037e0a16ef50 |
| institution | Kabale University |
| issn | 2090-8083 2042-0080 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Parkinson's Disease |
| spelling | doaj-art-f6cfbc83dfe944958088037e0a16ef502025-02-03T06:13:14ZengWileyParkinson's Disease2090-80832042-00802012-01-01201210.1155/2012/459321459321Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for TreatmentMeir Plotnik0Nir Giladi1Jeffrey M. Hausdorff2Laboratory for Gait and Neurodynamics, Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelLaboratory for Gait and Neurodynamics, Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelLaboratory for Gait and Neurodynamics, Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelSeveral gait impairments have been associated with freezing of gait (FOG) in patients with Parkinson's disease (PD). These include deteriorations in rhythm control, gait symmetry, bilateral coordination of gait, dynamic postural control and step scaling. We suggest that these seemingly independent gait features may have mutual interactions which, during certain circumstances, jointly drive the predisposed locomotion system into a FOG episode. This new theoretical framework is illustrated by the evaluation of the potential relationships between the so-called “sequence effect”, that is, impairments in step scaling, and gait asymmetry just prior to FOG. We further discuss what factors influence gait control to maintain functional gait. “Triggers”, for example, such as attention shifts or trajectory transitions, may precede FOG. We propose distinct categories of interventions and describe examples of existing work that support this idea: (a) interventions which aim to maintain a good level of locomotion control especially with respect to aspects related to FOG; (b) those that aim at avoiding FOG “triggers”; and (c) those that merely aim to escape from FOG once it occurs. The proposed theoretical framework sets the stage for testable hypotheses regarding the mechanisms that lead to FOG and may also lead to new treatment ideas.http://dx.doi.org/10.1155/2012/459321 |
| spellingShingle | Meir Plotnik Nir Giladi Jeffrey M. Hausdorff Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment Parkinson's Disease |
| title | Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment |
| title_full | Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment |
| title_fullStr | Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment |
| title_full_unstemmed | Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment |
| title_short | Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment |
| title_sort | is freezing of gait in parkinson s disease a result of multiple gait impairments implications for treatment |
| url | http://dx.doi.org/10.1155/2012/459321 |
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