An Objective Assessment to Investigate the Impact of Turning Angle on Freezing of Gait in Parkinson's Disease

Freezing of gait (FoG) is often described in subjects with Parkinson's disease (PD) as a sudden inability to continue the forward walking progression. FoG occurs most often during turning, especially at sharp angles. Here, we investigated 180 and 360 degrees turns in two groups: PD subjects reporting FoG (FoG+), and PD subjects without FoG (FoG-). Forty-three subjects (25 FoG+, 18 FoG-) wore an inertial sensor on their back while walking back and forth continuously for 2 min (reversing direction with a 180 degrees turn), and while turning in place for 1 min (alternating 360 degrees turning in opposite directions). Objective measures (turn duration, peak velocity, jerkiness and range of acceleration) were computed during the turns and compared across FoG+ and FoG- groups. Results showed that FoG+ compared to FoG- took significantly a longer time to complete 360 degrees turns than 180 degrees turns. A significant lower turn peak velocity, higher jerkiness and an increased range of medio-lateral acceleration was also found in FoG+. Significant differences between the two groups across the two turning tasks validated the hypothesis that sharper turns might cause higher instability in FoG+ compared to FoG-.