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Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease
Published on: July 24, 2019
Does freezing in Parkinson's disease change limb coordination? A kinematic analysis
Nieuwboer Alice1, Chavret Fabienne, Willems Anne-Marie
1Dept. of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Heverlee, Belgium. alice.nieuwboer@faber.kuleuven.be
Journal of Neurology
|April 3, 2007
Summary
Gait freezing in patients involves significantly reduced joint movement ranges, particularly in the ankle and hip, distinguishing it from voluntary stops. Side-dominant symptoms often precede freezing, with body-side differences exceeding step-to-step changes.
Area of Science:
- Neurology
- Biomechanics
- Gait Analysis
Background:
- Gait freezing is a common and debilitating symptom in neurological conditions.
- Understanding the kinematic precursors to freezing is crucial for developing targeted interventions.
- Previous research has focused on the characteristics of freezing itself, with less attention paid to the immediate pre-freezing phase.
Purpose of the Study:
- To analyze the kinematic characteristics of strides immediately preceding gait freezing.
- To compare these pre-freezing gait patterns with voluntary stops and normal walking.
- To investigate potential differences in gait profiles based on the dominant body side.
Main Methods:
- Ten patients with gait freezing underwent 3D motion analysis in a Vicon laboratory.
- Kinematic and spatiotemporal data were collected during normal walking, voluntary stops, and provoked freezing episodes.
- Multiple regression models for repeated measures were used to compare gait parameters between body sides and conditions.
Main Results:
- Pre-freezing strides exhibited significantly reduced sagittal plane movement ranges (31-61.5%), especially in the ankle and hip.
- Key kinematic changes included reduced ankle push-off, fixed dorsiflexion, increased hip and knee flexion, and anterior pelvic tilt.
- The body side experiencing the last complete stride before freezing showed significantly smaller joint ranges compared to the other side (p < .01).
- Body-side differences were more pronounced than the deterioration over consecutive steps.
Conclusions:
- Gait freezing is characterized by a substantial reduction in propulsive movements, distinct from normal gait deceleration.
- While step timing may be affected, overall movement patterns tend towards a flexed gait, with preserved dissociation between knee and hip in stance.
- The side of symptom dominance often, but not always, corresponds to the side where gait terminates before freezing.
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