Session Title: Phenomenology and Clinical Assessment of Movement Disorders
Session Time: 1:15pm-2:45pm
Location: Les Muses Terrace, Level 3
Objective: To determine whether gait parameters in PD patients who have freezing of gait (FOG) differ from those who do not.
Background: FOG is a motor symptom in PD patients that is often refractory to pharmacologic therapy, and leads to significant morbidity and mortality as a result of falls, fear of falling, and immobility. Perhaps what makes FOG so resistant to treatment is the fact that it seems to be both tied to the severity of other motor symptoms in PD but also to levels of anxiety and stress. Traditional DBS targets that can ameliorate other motor symptoms of PD are not usually effective in improving FOG, and may even worsen or trigger it. These post-surgical observations suggest that the central mechanisms underlying FOG may involve either more or divergent pathways in comparison to those thought to be involved in the traditional motor PD symptoms of rigidity and tremor. Studies have compared various PD rating scales, patient reported levels of stress, and in-office exams of patients with and without freezing. Notably, PD patients can have advanced motor symptoms and never manifest FOG. However, there is still a lack of understanding of whether there are specific differences in gait in PD patients who freeze and those who do not. We examined parameters of gait in real-time to better understand the differences between freezing and non-freezing PD patients.
Method: We recruited PD patients who either reported FOG or had been observed with FOG. Patients were recorded on video while walking on an electronic gait mat and wearing a footwear device (SoleSound) developed at the laboratory of Dr. Sunil Agrawal to study gait. The SoleSound system is an insole device that has underfoot pressure sensors enabling it to examine various spatial and temporal parameters of gait in real time. We are comparing gait parameters between patients who freeze and do not freeze while in office, and between patients who report freezing and those who do not report freezing.
Results: We have preliminarily examined 11 PD patients, 4 who exhibited freezing and 7 who did not exhibit freezing in office, and found mostly similar gait parameters between the groups. A further 13 PD patients have been recruited into the study.
Conclusion: We are gaining a better understanding of gait characteristics in PD patients who exhibit FOG and those who do not using a footwear device that allows us to quantitate various gait parameters.
To cite this abstract in AMA style:K. Kwei, A. De-La Mora, D. Payne, D. Tomishon, S. Agrawal, N. Vanegas-Arroyave. Quantifying gait parameters in Parkinson’s disease patients who do and do not exhibit freezing of gait. [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/quantifying-gait-parameters-in-parkinsons-disease-patients-who-do-and-do-not-exhibit-freezing-of-gait/. Accessed December 1, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/quantifying-gait-parameters-in-parkinsons-disease-patients-who-do-and-do-not-exhibit-freezing-of-gait/