Date: Wednesday, June 22, 2016
Session Title: Phenomenology and clinical assessment of movement disorders
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To compare those with and without freezing of gait (FOG) in Parkinson’s disease (PD).
Background: The presence of FOG in PD has been shown to be related to postural instability and fall history. Some have asserted that this is a distinct phenotype with specific demographic, motor, non-motor, and genetic features. Further comparison is warranted.
Methods: Fifty-eight individuals with PD were dichotomized on FOG using a score >1 on Part II item 13 of the Unified Parkinson’s disease Rating Scale (UPDRS): FOG (n=9, age=68.6±7.0, males=6) and nonFOG (n=49, age=72.9±9.6, males=39). They were compared using five domains: 1. demographics (age, gender, year of diagnosis, socioeconomic status (SES), education); 2. PD symptoms (UPDRS, Parkinson’s disease Questionnaire (PDQ-39)); 3. balance and falls (fall history, Berg Balance Scale (BBS), Timed UP and Go Test (TUGT), Activities Specific Balance Scale, Falls Efficacy Scale (FES), Catastrophizing About Falls Scale, Fear of Falling Avoidance Behavior Questionnaire (FFABQ)); 4. strength and conditioning (2-minute step test, 30 second Sit to Stand Test (STS), activity monitor data); and, 5. mental and cognitive function (Mini Mental State Exam, Zung Anxiety Scale, Beck Depression Inventory).
Results: There were no differences on any demographic factor (ps≥.127). PD motor-related dysfunction was more extensive in the FOG subtype: UPDRS Part II and III (ps≤.041) and PDQ mobility (p=.021). The FOG subtype had a more extensive and recent fall history (ps≤.033), poorer BBS scores (p=.004), slower TUGT times (p=.048), higher FES scores (p=.032), and higher FFABQ scores (p=.031). Also, the FOG subtype had fewer up/downs on the STS and spent less time daily in stepping (p=.009), more time sitting/laying (p=.034), fewer metabolic equivalents (p=.023), and fewer daily steps (p=.014) and up/down transitions (p=.007). There were no differences for the mental and cognitive factors (ps>.135).
Conclusions: Our results support previous data that the FOG subtype has a more extensive fall history and fall risk based on measures of gait and balance performance and balance self-efficacy. The FOG subtype exhibited more fear of falling avoidance behavior which was supported by activity monitor data indicating less participation in daily physical activity.
To cite this abstract in AMA style:M.R. Landers, B. Poston, J. Nash, J. Longhurst. Freezing of gait is associated with more fear of falling avoidance behavior and less participation in daily physical activity [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/freezing-of-gait-is-associated-with-more-fear-of-falling-avoidance-behavior-and-less-participation-in-daily-physical-activity/. Accessed September 28, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/freezing-of-gait-is-associated-with-more-fear-of-falling-avoidance-behavior-and-less-participation-in-daily-physical-activity/