Spatial constraints evoke increased number of steps during turning in Parkinsońs disease

Publication date: Available online 25 July 2017
Source:Clinical Neurophysiology
Author(s): Urban M. Fietzek, Lisa Stuhlinger, Annika Plate, Andres Ceballos-Baumann, Kai Bötzel
ObjectiveTurning and limitations to step length were shown to trigger progressive shortening of steps, which can lead to freezing of gait. By reducing the base area in which the turn had to take place, we aimed to evaluate the contribution of spatial constraints on 360° axial turns in people with Parkinson's disease with and without freezing.MethodsWe evaluated 40 patients with and without freezing and 16 age-matched healthy subjects. We assessed clinical data, and used body-worn inertial sensors to describe stepping and turn duration of 360° in quadratic squares of different sizes marked on the floor.ResultsWe found that, when subjects had to perform turns in smaller as compared to larger squares, this spatial constraint strongly affected the turning behavior, i.e. increased the number of steps, and the duration of turns. However, turning was significantly more impaired in patients as compared to controls, and patients with freezing were significantly worse as patients without freezing.ConclusionOur data show that spatial constraint during axial turning has the potential to deteriorate stepping performance, especially in patients reporting freezing of gait.SignificanceThe size of the base area needs to be defined in any item or scale that makes diagnostic use of turning.



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