Externally provoked freezing of gait in open runways in advanced Parkinson's disease results from motor and mental collapse
| Autor: | Pierre Krystkowiak, Luc Defebvre, Alain Duhamel, Alain Destée, J.L. Blatt, Bastiaan R. Bloem, S. Bleuse, Caroline Moreau |
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| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Parkinson's disease genetic structures Clinical Neurology STRIDE Walking Physical medicine and rehabilitation Cognitive neurosciences [UMCN 3.2] medicine Humans Gait Gait Disorders Neurologic Collapse (medical) Biological Psychiatry Aged Human Movement & Fatigue [NCEBP 10] Work (physics) Parkinson Disease Stride length medicine.disease Preferred walking speed Psychiatry and Mental health Neurology Physical therapy Neurology (clinical) medicine.symptom Cadence Psychology Functional Neurogenomics [DCN 2] human activities Stress Psychological |
| Zdroj: | Journal of Neural Transmission, 115, 1431-6 Journal of Neural Transmission, 115, 10, pp. 1431-6 |
| ISSN: | 0300-9564 |
| Popis: | Contains fulltext : 70316.pdf (Publisher’s version ) (Closed access) Freezing of gait (FOG) in Parkinson's disease (PD) is defined as a sudden inability to maintain effective stepping movements. However, its pathophysiology remains unclear. The objectives are: (1) To assess the contribution of both spatial (walking speed, stride length) and temporal parameters (cadence, stride time) and their coefficients of variation to the genesis of FOG in PD. (2) To evaluate whether and how externally imposed modifications of self-determined gait would elicit FOG. We included ten patients with advanced PD, and with daily off drug FOG episodes. We focused on walking in an open runway. For each subject, we manipulated gait by externally imposing four changes in walking speed and four changes in cadence. FOG episodes, often with a long duration of more than 5-s, were observed mostly under conditions with a high imposed cadence. The steps that immediately preceded these episodes were mainly characterized by an increase in cadence and an increase in stride length variability. The results also underscore that FOG can be elicited in a laboratory setting when patients are placed under considerable strain, at least in advanced stages of PD. Patients were unable to adequately negotiate the extreme imposed cadence condition, and this resulted in frequent FOG episodes, even while walking in an open runway. Placing advanced PD patients into extreme imposed conditions leads to a motor wise and mental collapse response, culminating in FOG. Future work should establish the relevance of these findings for the more common forms of FOG, including brief episodes during turning or gait initiation. |
| Databáze: | OpenAIRE |
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