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Fietzek, Urban M.; Stuhlinger, Lisa; Plate, Annika; Ceballos-Baumann, Andres; Bötzel, Kai (2017): Spatial constraints evoke increased number of steps during turning in Parkinson's disease. In: Clinical Neurophysiology, Vol. 128, No. 10: pp. 1954-1960
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Abstract

Objective: Turning and limitations to step length were shown to trigger progressive shortening of steps, which can lead to freezing of gait. By reducing the base area in which the turn had to take place, we aimed to evaluate the contribution of spatial constraints on 360 degrees axial turns in people with Parkinson's disease with and without freezing.& para;& para;Methods: We evaluated 40 patients with and without freezing and 16 age-matched healthy subjects. We assessed clinical data, and used body-worn inertial sensors to describe stepping and turn duration of 360 degrees in quadratic squares of different sizes marked on the floor.& para;& para;Results: We found that, when subjects had to perform turns in smaller as compared to larger squares, this spatial constraint strongly affected the turning behavior, i.e. increased the number of steps, and the duration of turns. However, turning was significantly more impaired in patients as compared to controls, and patients with freezing were significantly worse as patients without freezing.& para;& para;Conclusion: Our data show that spatial constraint during axial turning has the potential to deteriorate stepping performance, especially in patients reporting freezing of gait.& para;& para;Significance: The size of the base area needs to be defined in any item or scale that makes diagnostic use of turning. (C) 2017 International Federation of Clinical Neurophysiology.