Abstract
Freezing of Gait (FOG) is one of the most disturbing symptoms in advanced stage of Parkinson's disease (PD) that is strongly associated with recurrent falls and reduced functional independence. The purpose of the study was to determine the impact of FOG on mobility in terms of risk of falls, walking aids utilization and assistance-seeking behaviour by comparing freezers (FRs) and nonfreezers (NFRs). Clinical and demographic data, including disease duration, stage and characteristics, cognition, edication, history of falls, walking aids utilization, and assistanceseeking behaviour was collected from 102 subjects with PD from three medical centres in Belgium, Israel, and UK. Association between FOG and other disease characteristics, medication, falls, walking aids, and need for carers' assistance was investigated. Comparing FRs and NFRs showed significant difference in history of previous falls, walking aids utilization, and need for carers' assistance. More than half of the FRs reported previous fall and a need for walking aids for mobility compared to 20% in NFRs group. A vicious cycle exists among subjects with PD who experience FOG. Gait freezing induces increased risk and frequency of falls as well as increased fear of falling, which in turn increases the tendency towards higher reliance on carers' assistance and more utilization of walking aids.
Highlights
Freezing of gait (FOG) is a frequent phenomenon in subjects with Parkinson’s disease (PD), with prevalence rates ranging from 7% in the early stages of PD to about 60% in the more advanced stages (Bartels, Balash, Gurevich, Schaafsma, Hausdorff, & Giladi, 2003; Giladi et al, 2001a; Giladi et al, 2001b; Lamberti et al, 1997). Giladi et al (2001a) stated that 53% of those with disease duration of more than five years develop FOG
Disease characteristics were explored by completing part three of the Unified Parkinson’s Disease Rating Scale (UPDRS-III), which investigates the impact of PD on the motor function, in addition to question 14 (Q-14) of part two of the scale (UPDRS-II), which investigates the frequency of occurrence of FOG and its impact on walking and falls (Fahn & Elton, 1987)
Question 14 of the UPDRS-II is mainly concerned with the impact of falls and FOG on the daily life activities, while New Freezing of Gait Questionnaire (NFOG-Q) was constructed to assess the different aspects of FOG including presence, severity in terms of duration and frequency, and the impact on function and activities
Summary
Freezing of gait (FOG) is a frequent phenomenon in subjects with Parkinson’s disease (PD), with prevalence rates ranging from 7% in the early stages of PD to about 60% in the more advanced stages (Bartels, Balash, Gurevich, Schaafsma, Hausdorff, & Giladi, 2003; Giladi et al, 2001a; Giladi et al, 2001b; Lamberti et al, 1997). Giladi et al (2001a) stated that 53% of those with disease duration of more than five years develop FOG. Freezing of gait (FOG) is a frequent phenomenon in subjects with Parkinson’s disease (PD), with prevalence rates ranging from 7% in the early stages of PD to about 60% in the more advanced stages (Bartels, Balash, Gurevich, Schaafsma, Hausdorff, & Giladi, 2003; Giladi et al, 2001a; Giladi et al, 2001b; Lamberti et al, 1997). FOG is a transient halt of gait, lasting
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