The sequence effect and gait festination in Parkinson disease: contributors to freezing of gait?

@article{citeulike:2163633, abstract = {Festination and freezing of gait (FOG) are poorly understood gait disorders that cause disability and falls in people with Parkinson disease (PD). In PD, basal ganglia malfunction leads to motor set deficits (hypokinesia), while altered motor cue production leads to a sequence effect, whereby movements becomes progressively smaller as in festination. We suggest both factors may contribute to FOG. Disturbance of set maintenance by the basal ganglia in PD has previously been examined in gait, but limited systematic evaluation of the sequence effect exists. In this study, we investigated the step-to-step amplitude relationship in 10 PD subjects with clinical evidence of festination and FOG. Four conditions were examined: off levodopa, off with attentional strategies, off with visual cues, and on levodopa. Participants demonstrated a sequence effect (F = 6.24; P = 0.001), which was reversed only by use of visual cues. In contrast, medication, attentional strategies, and visual cues all improved hypokinesia. Variability was marked both within and between participants in all conditions. The variability of FOG is suggested to relate to a combination of factors, including the sequence effect and its variability, as well as the severity of hypokinesia and its response to medications.}, address = {Geriatric Research Unit, Kingston Centre Southern Health, Melbourne, Australia.}, author = {Iansek, R. and Huxham, F. and McGinley, J.}, citeulike-article-id = {2163633}, doi = {10.1002/mds.20998}, issn = {0885-3185}, journal = {Mov Disord}, keywords = {fog, gait, parkinsonism}, month = {September}, number = {9}, pages = {1419--1424}, posted-at = {2007-12-24 12:07:49}, priority = {2}, title = {The sequence effect and gait festination in Parkinson disease: contributors to freezing of gait?}, url = {http://dx.doi.org/10.1002/mds.20998}, volume = {21}, year = {2006} }

TY - JOUR ID - citeulike:2163633 L3 - citeulike-article-id:2163633 N2 - Festination and freezing of gait (FOG) are poorly understood gait disorders that cause disability and falls in people with Parkinson disease (PD). In PD, basal ganglia malfunction leads to motor set deficits (hypokinesia), while altered motor cue production leads to a sequence effect, whereby movements becomes progressively smaller as in festination. We suggest both factors may contribute to FOG. Disturbance of set maintenance by the basal ganglia in PD has previously been examined in gait, but limited systematic evaluation of the sequence effect exists. In this study, we investigated the step-to-step amplitude relationship in 10 PD subjects with clinical evidence of festination and FOG. Four conditions were examined: off levodopa, off with attentional strategies, off with visual cues, and on levodopa. Participants demonstrated a sequence effect (F = 6.24; P = 0.001), which was reversed only by use of visual cues. In contrast, medication, attentional strategies, and visual cues all improved hypokinesia. Variability was marked both within and between participants in all conditions. The variability of FOG is suggested to relate to a combination of factors, including the sequence effect and its variability, as well as the severity of hypokinesia and its response to medications. IS - 9 JF - Mov Disord SN - 0885-3185 AD - Geriatric Research Unit, Kingston Centre Southern Health, Melbourne, Australia. EP - 1424 TI - The sequence effect and gait festination in Parkinson disease: contributors to freezing of gait? VL - 21 SP - 1419 KW - fog KW - gait KW - parkinsonism AU - Iansek, R AU - Huxham, F AU - McGinley, J PY - 2006/09// UR - http://dx.doi.org/10.1002/mds.20998 ER -