What is it about?

In this prospective study, people with Parkinson's disease who had not yet developed gait freezing were followed-up for two years and assessed each year. To investigate the most sensitive markers of the onset of gait freezing, participants performed walking, turning, balance tasks and repetitive hand and foot movements besides extensive neuro-psychological testing. Markers of developing gait freezing were investigated and a predictive model was built using pre-conversion information. Difficulties during repetitive hand and foot movements as well as walking asymmetry were predictive of conversion. Cognitive and autonomic disturbances were reported pre-conversion although cognitive performance was not more impaired. These results provide novel insights into specific motor deficits predicting conversion to gait freezing.

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Why is it important?

This is the first time objective measures of motor performance have been assessed in a prospective manner in relationship to freezing of gait. These results provide specific therapeutic targets to investigate whether improving these would delay or possibly prevent the onset of gait freezing in Parkinson's disease. Further, the predictive model showed that a commonly used clinical scale contained information that could predict the onset of gait freezing, which may be quickly developed into a screening tool for risk assessment and early intervention.


This study was set up to investigate freezing and all measures were investigated in OFF medication over a few years, which is very challenging to do. In that sense, this work is fairly novel compared to all the other longitudinal work in freezing out there. Having said that, our clinical findings are in line with other clinical studies, and we add novel information with regards to the objective motor markers and the relevance of the various domains of behavior (motor/cognitive/affective/autonomic) in predicting gait freezing.

Nicholas D'Cruz

Read the Original

This page is a summary of: Repetitive Motor Control Deficits Most Consistent Predictors of Conversion to Freezing of Gait in Parkinson’s Disease: A Prospective Cohort Study, Journal of Parkinson s Disease, April 2020, IOS Press, DOI: 10.3233/jpd-191759.
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