Citation

Bertoli M, Croce UD, Cereatti A, Mancini M. Gait Posture 2019; 74: 187-193.

Affiliation

Department of Neurology, Oregon Health & Science University, Portland, OR, United States.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.gaitpost.2019.09.001

PMID

31539800

Abstract

BACKGROUND: Turning is impaired in people with Parkinson's Disease (PD) and it is a common trigger for freezing of gait (FoG). Recent evidence suggests that people with PD who freeze (PD+FoG) have worse turning performance than those who don't have freezing (non-freezers, PD-FoG), and the freezing episodes are exacerbated by increasing the turn angular amplitude. RESEARCH QUESTION: We investigated the difference between turning 180° while walking versus turning 360° in place, in both single- and dual-task conditions, by means of objective measures in people with PD with and without FoG.

METHODS: Twenty-four PD+FoG and eighteen PD-FoG performed 180° turns while walking and 360° turns in place during single- and dual-task conditions. Quantitative measures of turning and the dual-task cost were computed. Differences were investigated between groups and within turning types using ANOVA. Associations between turn measures and clinical scales were examined with Spearman correlations.

RESULTS: Turn duration and the number of steps were greater, and peak angular velocity slower, in PD+FoG compared to PD-FoG (p < 0.001). Dual-task costs were similar across groups, but turn duration showed significant interaction (p = 0.03). Posture Instability and Gait Disability (PIGD) subscore was associated with all turn measures in PD-FoG; whereas PIGD was mainly associated with turning while walking in PD+FoG. SIGNIFICANCE: Objective measures of turning revealed differences between people with and without FoG, specifically, people with FoG showed more impairments in 360° turning in place compared to 180° turning while walking. However, as the turning challenges were increased by adding a dual-task, results from PD+FoG were similar to those from PD-FoG.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

Keywords

Dual-task; Freezing of gait; Inertial measurement unit; Parkinson’s disease; Turning