Article

Patients with freezing of gait (FOG) have more difficulty with
switching tasks as well as controlling the spatiotemporal parameters of gait than
patients without FOG. Objective. To compare the ability of patients with and
without FOG to adjust their gait to sudden speed switching and to prolonged
walking in asymmetrical conditions. METHODS: Gait characteristics of 10 freezers,
12 non-freezers, and 12 controls were collected during tied-belt conditions (3
and 4 km/h), motor switching and reswitching (increase of speed in one belt from
3 to 4 km/h and vice versa), and adaptation (adjustment to asymmetrical gait) and
re-adaptation (returning to symmetrical gait) on a split-belt treadmill. RESULTS:
Following switching, freezers showed the largest increase of step length
asymmetry (P = .001). All groups gradually adapted their gait to asymmetrical
conditions, but freezers were slower and demonstrated larger final asymmetry than
the other 2 groups (P = .001). After reswitching, freezers again showed the
largest step length asymmetry (P = .01). During re-adaptation, both controls and
non-freezers reached symmetrical levels, but freezers did not. Interestingly,
only immediately after switching did one episode of FOG and one episode of
festination occur in 2 different patients. CONCLUSIONS: Freezers have more
difficulties adapting their gait during both suddenly triggered and continued
gait speed asymmetry.
The impaired ability of freezers during both switching and
reswitching would suggest that they have an adaptive deficit rather than
difficulties with asymmetry per se. Future work needs to address whether these
adaptation problems can be ameliorated with rehabilitation.

Langue : ANGLAIS