Category: Parkinsonism, Others
Objective: The aim of this study was to investigate the difference in the preference of staircase climbing in PD and atypical/ secondary parkinsonism when they experience freezing of gait and the feasibility of this simple question for the differential diagnosis of parkinsonism.
Background: Freezing of gait (FOG) is common in advanced Parkinson’s disease (PD) and more common in atypical and secondary parkinsonism as well. FOG can be seen even in the early stages of various parkinsonisms. There has been still no widespread standard method in management of FOG including medical treatment, surgical intervention, and exercise programs. Until now, cueing is most widely used ancillary method for rescue of FOG in PD and some PD patients who suffer from gait initiation failure prefer going up stairs or climbing mountain than floor walking.
Method: 46 patients with PD, 30 patients with atypical and secondary parkinsonism were enrolled in this study. 4 suggested questions were asked to all patients. FOG during normal walking was assessed by FOG questionnaire (FOGQ) score. The preference of stairs climbing and regular walking to initiate first step when the patients experienced FOG named “staircase sign” was investigated. The status of bicycle riding was also collected. The correlation between climbing stairs and bicycle riding was also performed.
Results: The number of falling was more frequent in atypical and secondary parkinsonism, whereas the improvement of FOG by cueing was common in PD. FOGQ score was higher in atypical and secondary parkinsonism. Stairs climbing and bicycle riding were better performed in PD than atypical and secondary parkinsonism. Patient with PD preferred stairs climbing than regular walking to initiate step, while patients with atypical and secondary parkinsonism had difficulties in stair climbing than regular walking.
Conclusion: FOG was more frequent in atypical and secondary parkinsonism than PD. Assessment of the ability to climb staircases with simple questions might be a useful tool for differentiating PD from atypical and secondary parkinsonism.
To cite this abstract in AMA style:Y.S Oh, J.S Kim, D.Y Kwon, M.H Park, B.R Bloem. Staircase sign for Atypical and Secondary parkinsonism [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/staircase-sign-for-atypical-and-secondary-parkinsonism/. Accessed December 5, 2023.
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