@article{ref1,
title="The new freezing of gait questionnaire: unsuitable as an outcome in clinical trials?",
journal="Movement disorders clinical practice",
year="2020",
author="Hulzinga, Femke and Nieuwboer, Alice and Dijkstra, Bauke W. and Mancini, Martina and Strouwen, Carolien and Bloem, Bastiaan R. and Ginis, Pieter",
volume="7",
number="2",
pages="199-205",
abstract="BACKGROUND: Freezing of gait (FOG) is a common gait deficit in Parkinson's disease. The New Freezing of Gait Questionnaire (NFOG-Q) is a widely used and valid tool to quantify freezing of gait severity. However, its test-retest reliability and minimal detectable change remain unknown.
OBJECTIVE: To determine the test-retest reliability and responsiveness of the NFOG-Q.
METHODS: Two groups of freezers, involved in 2 previous rehabilitation trials, completed the NFOG-Q at 2 time points (T1 and T2), separated by a 6-week control period without active intervention. Sample 1 (N = 57) was measured in ON and sample 2 (N = 14) in OFF. We calculated various reliability statistics for the NFOG-Q scores between T1 and T2 as well as correlation coefficients with clinical descriptors to explain the variability between time points.
RESULTS: In sample 1 the NFOG-Q showed modest reliability (intraclass correlation coefficient = 0.68 [0.52-0.80]) without differences between T1 and T2. However, a minimal detectable change of 9.95 (7.90-12.27) points emerged for the total score (range 28 points, relative minimal detectable change of 35.5%). Sample 2 showed largely similar results. We found no associations between cognitive-related or disease severity-related outcomes and variability in NFOG-Q scores.
CONCLUSIONS: We conclude that the NFOG-Q is insufficiently reliable or responsive to detect small effect sizes, as changes need to go beyond 35% to surpass measurement error. Therefore, we warrant caution in using the NFOG-Q as a primary outcome in clinical trials. These results emphasize the need for robust and objective freezing of gait outcome measures.
© 2020 International Parkinson and Movement Disorder Society.
Language: en
", language="en", issn="2330-1619", doi="10.1002/mdc3.12893", url="http://dx.doi.org/10.1002/mdc3.12893" }