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Parkinson’s Disease
Volume 2011, Article ID 202937, 8 pages
http://dx.doi.org/10.4061/2011/202937
Clinical Study

Abnormalities of the First Three Steps of Gait Initiation in Patients with Parkinson's Disease with Freezing of Gait

1Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka 583-8555, Japan
2Faculty of Health Science, Kio University, Nara 635-0832, Japan
3Department of Physical Therapy, Nishiyamato Rehabilitation Hospital, Nara 639-0214, Japan
4School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka 583-8555, Japan

Received 26 February 2011; Revised 28 April 2011; Accepted 2 June 2011

Academic Editor: Katherine Grosset

Copyright © 2011 Yohei Okada et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of this study was to investigate abnormalities of the first three steps of gait initiation in patients with Parkinson's disease (PD) with freezing of gait (FOG). Ten PD patients with FOG and 10 age-matched healthy controls performed self-generated gait initiation. The center of pressure (COP), heel contact positions, and spatiotemporal parameters were estimated from the vertical pressures on the surface of the force platform. The initial swing side of gait initiation was consistent among the trials in healthy controls but not among the trials in PD patients. The COP and the heel contact position deviated to the initial swing side during the first step, and the COP passed medial to each heel contact position during the first two steps in PD patients. Medial deviation of the COP from the first heel contact position had significant correlation with FOG questionnaire item 5. These findings indicate that weight shifting between the legs is abnormal and that medial deviation of the COP from the first heel contact position sensitively reflects the severity of FOG during the first three steps of gait initiation in PD patients with FOG.