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The Practicalities of Assessing Freezing of Gait

Barthel, C; Mallia, E; Debû, B; Bloem, BR; Ferraye, MU; (2016) The Practicalities of Assessing Freezing of Gait. Journal of Parkinson's Disease , 6 (4) pp. 667-674. 10.3233/JPD-160927. Green open access

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Abstract

BACKGROUND: Freezing of gait (FOG) is a mysterious, complex and debilitating phenomenon in Parkinson’s disease. Adequate assessment is a pre-requisite for managing FOG, as well as for assigning participants in FOG research. The episodic nature of FOG, as well as its multiple clinical expressions make its assessment challenging. OBJECTIVE: To highlight the available assessment tools and to provide practical, experience-based recommendations for reliable assessment of FOG. METHODS: We reviewed FOG assessment from history taking, questionnaires, lab and home-based measurements and examined how these methods account for presence and severity of FOG, their limits and advantages. The practicalities for their use in clinical and research practice are highlighted. RESULTS: According to the available assessment tools severity of FOG is marked by one or a combination of multiple clinical expressions including frequency, duration, triggering circumstances, response to levodopa, association with falls and fear of falling, or need for assistance to avoid falls. CONCLUSIONS: To date, a unique methodological tool that encompasses the entire complexity of FOG is lacking. Combining methods should give a better picture of FOG severity, in accordance with the precise clinical or research context. Further development of any future assessment tool requires understanding and thorough analysis of the specific clinical expressions of FOG.

Type: Article
Title: The Practicalities of Assessing Freezing of Gait
Open access status: An open access version is available from UCL Discovery
DOI: 10.3233/JPD-160927
Publisher version: http://dx.doi.org/10.3233/JPD-160927
Additional information: © IOS Press and the authors. All rights reserved. This article is published online with Open Access and distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC 4.0).
Keywords: Parkinson disease, gait disorders, neurologic, disability, evaluation, objective measure
UCL classification: UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Neurology
URI: http://discovery.ucl.ac.uk/id/eprint/1545272
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