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Abstract Details

Jumping as a Strategy to Overcome Freezing of Gait while Turning in Parkinson’s Disease
Movement Disorders
P5 - Poster Session 5 (5:30 PM-6:30 PM)
10-044
To evaluate jumping as a strategy to overcome treatment-resistant freezing of gait (FOG) while turning (turning-FOG) in a cohort of patients with Parkinson’s disease (PD).
FOG is disabling, progressive and treatment-resistant. Cueing is initially effective but requires training, devices and may increase FOG and falls. Turning is the most common FOG trigger, however few studies have focused on strategies targeting turning-FOG.
Over one year, FOG questionnaires and UPDRS-PIGD subscales were obtained from consecutive patients with PD and turning-FOG resistant to medications, subthalamic stimulation and other compensatory strategies. These patients were assessed for their abilities to jump in order to overcome turning-FOG. Quantitative video-documented pivot-turn analyses were performed with and without jumping with a six-meter walkway and dedicated movement analysis software (Zeno walkway®). Selected patients continued using the jumping strategy at home as safely as possible. Follow-up FOG questionnaires and UPDRS-PIGD subscales were obtained three months later.
 Five of nine PD patients with treatment-resistant turning-FOG could jump to overcome turning-FOG. For patient 1, left turn improved from 2.983 seconds, 12 steps and 2.20 FOG seconds to 2.267 seconds, seven steps and 0.90 FOG seconds. For patient 2, right turn improved from 6.142 seconds, 15 steps and 5.892 FOG seconds to 2.20 seconds, seven steps and 1.01 FOG seconds. For patient 3, right turn improved from 2.875 seconds, 11 steps and 1.62 FOG seconds to 2.034 seconds, five steps and 0.30 FOG seconds. The two other patients required walkers that precluded quantitative pivot-turn analysis. Three months later, the FOG questionnaire improved from a median of 12 (range 10-16) to 10 points (range 8-15) and the UPDRS-PIGD score improved from a median of 11 (range 9-16) to 10 points (range 8-14), without an increase in reported falls.

Jumping might be effective and relatively safe for selected PD patients to overcome treatment-resistant turning-FOG.
Authors/Disclosures
Karlo J. Lizarraga, MD, MS, FAAN (University of Rochester)
PRESENTER 		Dr. Lizarraga has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for FHC. The institution of Dr. Lizarraga has received research support from BlueRock. The institution of Dr. Lizarraga has received research support from Roche. The institution of Dr. Lizarraga has received research support from NIH/NINDS. Dr. Lizarraga has received personal compensation in the range of $500-$4,999 for serving as a Speaker with International Parkinson and Movement Disorders Society. Dr. Lizarraga has received personal compensation in the range of $0-$499 for serving as a Reviewer with National Institutes of Health. Dr. Lizarraga has a non-compensated relationship as a Editorial Board Member for Brain & Life with 好色先生 that is relevant to AAN interests or activities.
No disclosure on file
Alfonso Fasano, MD, PhD, FAAN (Toronto Western Hospital - U of Toronto) Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Fasano has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ipsen. Dr. Fasano has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbott. Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ceregate. Dr. Fasano has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Inbrain Neuroelectronics. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Syneos Health. Dr. Fasano has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Annovis. Dr. Fasano has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for CADTH. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for International Parkinson and Movement Disorders Society. The institution of Dr. Fasano has received research support from Boston Scientific. The institution of Dr. Fasano has received research support from Medtronic. The institution of Dr. Fasano has received research support from Abbvie. The institution of Dr. Fasano has received research support from Canadian Institutes of Health Research (CIHR). The institution of Dr. Fasano has received research support from Michael J Fox Foundation. The institution of Dr. Fasano has received research support from Bluerock Therapeutics. Dr. Fasano has received publishing royalties from a publication relating to health care. Dr. Fasano has a non-compensated relationship as a Medical Advisory Committee with CenteR for Advancing Neurological Innovation to Application (CRANIA) that is relevant to AAN interests or activities. Dr. Fasano has a non-compensated relationship as a Medical Advisory Committee with HopeNET that is relevant to AAN interests or activities. Dr. Fasano has a non-compensated relationship as a Medical Advisory Committee with International Essential Tremor Foundation that is relevant to AAN interests or activities. Dr. Fasano has a non-compensated relationship as a Member with Tremor Research Group that is relevant to AAN interests or activities. Dr. Fasano has a non-compensated relationship as a Co-Chair with Tremor Study Group of the IPMDS that is relevant to AAN interests or activities. Dr. Fasano has a non-compensated relationship as a Vice-Chair with NPH Study Group of the IPMDS that is relevant to AAN interests or activities. Dr. Fasano has a non-compensated relationship as a Vice-Chair with Industry Committee of the IPMDS that is relevant to AAN interests or activities.
Anthony E. Lang, MD, FAAN (Toronto Western Hospital) Dr. Lang has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AbbVie, Amylyx, Aprinoia, Biogen, BioAdvance, Biohaven, BioVie, BlueRock, BMS, Denali, Janssen, Lilly, Pharma 2B, Sun Pharma, and UCB. Dr. Lang has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for medicolegal cases related to paraquat. The institution of Dr. Lang has received research support from AbbVie. Dr. Lang has received intellectual property interests from a discovery or technology relating to health care. Dr. Lang has received publishing royalties from a publication relating to health care.