Variability of Stepping During a Virtual Reality Paradigm in Parkinson's Disease Patients with and Without Freezing of Gait

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2013 Jun 28

PMID 23805270

Citations 17

Authors

Moran Gilat

James M Shine

Samuel J Bolitho

Elie Matar

Yvo P T Kamsma

Sharon L Naismith

Simon J G Lewis

Affiliations

Soon will be listed here.

Abstract

Background: Freezing of gait is a common and debilitating symptom affecting many patients with advanced Parkinson's disease. Although the pathophysiology of freezing of gait is not fully understood, a number of observations regarding the pattern of gait in patients with this symptom have been made. Increased 'Stride Time Variability' has been one of the most robust of these features. In this study we sought to identify whether patients with freezing of gait demonstrated similar fluctuations in their stepping rhythm whilst performing a seated virtual reality gait task that has recently been used to demonstrate the neural correlate of the freezing phenomenon.

Methods: Seventeen patients with freezing and eleven non-freezers performed the virtual reality task twice, once whilst 'On' their regular Parkinsonian medication and once in their practically defined 'Off' state.

Results: All patients displayed greater step time variability during their 'Off' state assessment compared to when medicated. Additionally, in the 'Off' state, patients with freezing of gait had greater step time variability compared to non-freezers. The five steps leading up to a freezing episode in the virtual reality environment showed a significant increase in step time variability although the final three steps preceding the freeze were not characterized by a progressive shortening of latency.

Conclusions: The results of this study suggest that characteristic features of gait disturbance observed in patients with freezing of gait can also be demonstrated with a virtual reality paradigm. These findings suggest that virtual reality may offer the potential to further explore the freezing phenomenon in Parkinson's disease.

Citing Articles

Knowledge mapping of freezing of gait in Parkinson's disease: a bibliometric analysis.

Jiao Y, Liu Z, Li J, Su Y, Chen X Front Neurosci. 2024; 18:1388326.

PMID: 39315077 PMC: 11417103. DOI: 10.3389/fnins.2024.1388326.

Stepping up to meet the challenge of freezing of gait in Parkinson's disease.

Lewis S, Factor S, Giladi N, Nieuwboer A, Nutt J, Hallett M Transl Neurodegener. 2022; 11(1):23.

PMID: 35490252 PMC: 9057060. DOI: 10.1186/s40035-022-00298-x.

The Contribution of Noradrenergic Activity to Anxiety-Induced Freezing of Gait.

Taylor N, Wainstein G, Quek D, Lewis S, Shine J, Ehgoetz Martens K Mov Disord. 2022; 37(7):1432-1443.

PMID: 35384055 PMC: 9540856. DOI: 10.1002/mds.28999.

Gait variability is affected more by peripheral artery disease than by vascular occlusion.

Rahman H, Pipinos I, Johanning J, Myers S PLoS One. 2021; 16(3):e0241727.

PMID: 33788839 PMC: 8011739. DOI: 10.1371/journal.pone.0241727.

Using Kinect v2 to Control a Laser Visual Cue System to Improve the Mobility during Freezing of Gait in Parkinson's Disease.

Amini A, Banitsas K J Healthc Eng. 2019; 2019:3845462.

PMID: 30915207 PMC: 6402218. DOI: 10.1155/2019/3845462.

References

Hausdorff J, Edelberg H, Mitchell S, Goldberger A, Wei J . Increased gait unsteadiness in community-dwelling elderly fallers. Arch Phys Med Rehabil. 1997; 78(3):278-83. DOI: 10.1016/s0003-9993(97)90034-4. View

Tomlinson C, Stowe R, Patel S, Rick C, Gray R, Clarke C . Systematic review of levodopa dose equivalency reporting in Parkinson's disease. Mov Disord. 2010; 25(15):2649-53. DOI: 10.1002/mds.23429. View

Gray P, Hildebrand K . Fall risk factors in Parkinson's disease. J Neurosci Nurs. 2000; 32(4):222-8. DOI: 10.1097/01376517-200008000-00006. View

Giladi N, Nieuwboer A . Understanding and treating freezing of gait in parkinsonism, proposed working definition, and setting the stage. Mov Disord. 2008; 23 Suppl 2:S423-5. DOI: 10.1002/mds.21927. View

Spildooren J, Vercruysse S, Desloovere K, Vandenberghe W, Kerckhofs E, Nieuwboer A . Freezing of gait in Parkinson's disease: the impact of dual-tasking and turning. Mov Disord. 2010; 25(15):2563-70. DOI: 10.1002/mds.23327. View

Nieuwboer A, Dom R, De Weerdt W, Desloovere K, Fieuws S . Abnormalities of the spatiotemporal characteristics of gait at the onset of freezing in Parkinson's disease. Mov Disord. 2001; 16(6):1066-75. DOI: 10.1002/mds.1206. View

Shine J, Ward P, Naismith S, Pearson M, Lewis S . Utilising functional MRI (fMRI) to explore the freezing phenomenon in Parkinson's disease. J Clin Neurosci. 2011; 18(6):807-10. DOI: 10.1016/j.jocn.2011.02.003. View

Goetz C, Tilley B, Shaftman S, Stebbins G, Fahn S, Martinez-Martin P . Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008; 23(15):2129-70. DOI: 10.1002/mds.22340. View

Lord S, Howe T, Greenland J, Simpson L, Rochester L . Gait variability in older adults: a structured review of testing protocol and clinimetric properties. Gait Posture. 2011; 34(4):443-50. DOI: 10.1016/j.gaitpost.2011.07.010. View

10.

Moore S, MacDougall H, Ondo W . Ambulatory monitoring of freezing of gait in Parkinson's disease. J Neurosci Methods. 2007; 167(2):340-8. DOI: 10.1016/j.jneumeth.2007.08.023. View

11.

IJmker T, Lamoth C . Gait and cognition: the relationship between gait stability and variability with executive function in persons with and without dementia. Gait Posture. 2011; 35(1):126-30. DOI: 10.1016/j.gaitpost.2011.08.022. View

12.

Giladi N, Treves T, Simon E, Shabtai H, Orlov Y, Kandinov B . Freezing of gait in patients with advanced Parkinson's disease. J Neural Transm (Vienna). 2001; 108(1):53-61. DOI: 10.1007/s007020170096. View

13.

Blin O, Ferrandez A, Serratrice G . Quantitative analysis of gait in Parkinson patients: increased variability of stride length. J Neurol Sci. 1990; 98(1):91-7. DOI: 10.1016/0022-510x(90)90184-o. View

14.

Moreau C, Defebvre L, Bleuse S, Blatt J, Duhamel A, Bloem B . Externally provoked freezing of gait in open runways in advanced Parkinson's disease results from motor and mental collapse. J Neural Transm (Vienna). 2008; 115(10):1431-6. DOI: 10.1007/s00702-008-0099-3. View

15.

Shine J, Matar E, Bolitho S, Dilda V, Morris T, Naismith S . Modeling freezing of gait in Parkinson's disease with a virtual reality paradigm. Gait Posture. 2012; 38(1):104-8. DOI: 10.1016/j.gaitpost.2012.10.026. View

16.

Shine J, Matar E, Ward P, Bolitho S, Gilat M, Pearson M . Exploring the cortical and subcortical functional magnetic resonance imaging changes associated with freezing in Parkinson's disease. Brain. 2013; 136(Pt 4):1204-15. DOI: 10.1093/brain/awt049. View

17.

Hausdorff J, Cudkowicz M, Firtion R, Wei J, Goldberger A . Gait variability and basal ganglia disorders: stride-to-stride variations of gait cycle timing in Parkinson's disease and Huntington's disease. Mov Disord. 1998; 13(3):428-37. DOI: 10.1002/mds.870130310. View

18.

Naismith S, Lewis S . A novel paradigm for modelling freezing of gait in Parkinson's disease. J Clin Neurosci. 2010; 17(8):984-7. DOI: 10.1016/j.jocn.2009.12.006. View

19.

Morris T, Cho C, Dilda V, Shine J, Naismith S, Lewis S . A comparison of clinical and objective measures of freezing of gait in Parkinson's disease. Parkinsonism Relat Disord. 2012; 18(5):572-7. DOI: 10.1016/j.parkreldis.2012.03.001. View

20.

Plotnik M, Hausdorff J . The role of gait rhythmicity and bilateral coordination of stepping in the pathophysiology of freezing of gait in Parkinson's disease. Mov Disord. 2008; 23 Suppl 2:S444-50. DOI: 10.1002/mds.21984. View