Objective: To elucidate plantar pressure characteristics in different stages of PD patients who experienced FOG and identify predictive factors for alterations in plantar pressure parameters.

Background: Decreased plantar pressure during the heel strike phase has been proposed as one of the pivotal factors contributing to freezing of gait (FOG) in Parkinson’s disease (PD) (Figure 1). However, its changes among all PD stages remain unknown. It is also interesting to explore the predictive factors for the alterations in plantar pressure in both heel strike and push off phase.

Method: One hundred PD patients with FOG identified from the FOG questionnaires were recruited to walk on the objective gait mat (Strideway^® System). Demographics, clinical data, rating scales, plantar pressure parameters including peak pressure during heel strike, push off, and spatiotemporal gait parameters were collected. Analysis of plantar pressure characteristics across all stages of PD was performed using the Kruskal-Wallis analysis. A logistic regression analysis was conducted to predict the reduction of plantar pressure in the heel strike phase, and the Wald criterion was used to determine the predictive independent variables.

Results: There were no significant differences in plantar pressure during the heel strike phase and the ratio of the plantar pressure during push off to heel strike across PD stages (p-value = 0.455,0.559; Figure 2). The predictive factors for a decrease in plantar pressure in the heel strike was only the MDS-UPDRS part III scores (b -2.08 95%CI -2.96 – -1.19; p < 0.001)(Table 1).

Conclusion: Our preliminary findings showed that the plantar pressure in both heel-strike and push-off phase was not different among PD stage, however increase motor severity could predict the decrement of plantar pressure in the heel-strike phase. This might explain that there might be reduction in dorsiflexion for forward progression of the body movement, leading to more frequent FOG in the more advanced stages of PD.

Figure 1

Figure 2

Table 1

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MDS Abstracts - https://www.mdsabstracts.org/abstract/unraveling-plantar-pressure-dynamics-in-parkinsons-disease-with-freezing-of-gait-taking-steps-through-its-characters-and-predictive-factors/