Compensatory mechanisms for motor control deficits in Parkinson's disease: understanding the relationship between cueing, cognition and underlying brain activity.

The most important gait problems in Parkinson Disease are turning and freezing of gait (FOG means an involuntary discontinuation of gait). A strong link between these two phenomena has been shown already, but how turning provokes FOG is still unclear. Since medication and surgical treatment influence these problems only to a limited extent, rehabilitation has been recommended. The objective of this study is to unravel the causes of freezing during turning and from these insights develop new rehabilitation methods, which will be tested in a second phase. The first study analysis the gait problems during 180° and 360° turning in both freezers and non-freezers. With 3D-gait analysis the intersegmental coordination, the displacement curves of the center of mass and the asymmetry of both the turn and the symptom-distribution itself are analyzed and are correlated with freezing. In the second study the link between freezing and turning will be studied by means of analysis of possible underlying interlimb coordination disorders, without the influence of postural factors and balance. By means of a rotating disc, an asymmetrical finger task is induced to provoke freezing as an experimental simulation of turning and is registered with Optotrack. The third study investigates the impact of new asymmetrical cueing methods on both freezing, postural factors and gait parameters during the turn with 3D-gait analysis.

Keywords:Parkinson's disease, Gait, Turning, Freezing, Rehabilitation

Disciplines:Education curriculum, Orthopaedics, Human movement and sports sciences, Rehabilitation sciences, Neurosciences, Biological and physiological psychology, Cognitive science and intelligent systems, Developmental psychology and ageing