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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24272

Title: Influence of Cueing and an Attentional Strategy on Freezing of Gait in Parkinson Disease During Turning
Authors: Spildooren, Joke
Vercruysse, Sarah
Heremans, Elke
Galna, Brook
Verheyden, Geert
Vervoort, Griet
Nieuwboer, Alice
Issue Date: 2017
Abstract: Background and Purpose: Individuals with Parkinson disease exhibit decreased axial head-pelvis rotation. Consequently, they turn more en bloc than healthy controls, which may contribute to freezing during turning. We wanted to understand the influence of auditory cueing and an attentional strategy on turning and how this related to freezing of gait (FOG). Methods: Fifteen participants with Parkinson disease and FOG were asked to turn 180. during baseline condition, unilateral cueing, and an attentional strategy prompting to start the turn with head rotation first. FOG occurrence, axial rotation, center of mass (COM) deviation, knee-flexion amplitude, and total turn velocity were measured using 3D motion analysis while off-medication. Normal reference values were obtained from 14 age-matched controls. Results: Thirty-nine FOG episodes occurred in 5 participants. FOG occurred in 52.8% of baseline trials compared with 34.6% of trials using the head-first strategy, and 3.8% of the auditory cueing trials. During the head first strategy, the initiation of head, trunk, and pelvic rotation as well as the head-pelvis separation resembled turning patterns of healthy controls, but the COM shift to the inside of the turn was exaggerated. By contrast, during cueing, turning became more en bloc, with decreased head-pelvis separation and knee-flexion amplitude. Discussion and Conclusions: Cueing reduced FOG but did not correct axial movement deficits. The head-first strategy improved head-pelvis dissociation but had only limited effects on FOG. These results suggest that axial and COM deviation impairments are not directly related to FOG but may rather indicate a compensatory mechanism. Cueing reinforced the en-bloc movement and might as such help prevent FOG by triggering an alternative neural mechanism for movement generation. Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A163).
Notes: [Spildooren, Joke; Vercruysse, Sarah; Heremans, Elke; Verheyden, Geert; Vervoort, Griet; Nieuwboer, Alice] KU Leuven Univ Leuven, Dept Rehabil Sci, Leuven, Belgium. [Spildooren, Joke] Hasselt Univ, Rehabil Sci & Physiotherapy, Hasselt, Belgium. [Galna, Brook] Newcastle Univ, Newcastle Univ Inst Ageing, Inst Neurosci, Newcastle Upon Tyne, Tyne & Wear, England.
URI: http://hdl.handle.net/1942/24272
DOI: 10.1097/NPT.0000000000000178
ISI #: 000402811000007
ISSN: 1557-0576
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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