Research Article
Forced Exercise for Freezing of Gait in Post STN DBS Parkinson's Disease Patients
Vanessa K Hinson1*, Amy Delambo1, Aaron E Embry2, Chris Gregory2, Kathryn Gaines3, Vicky Salak4 and Gonzalo J Revuelta1
1Department of Neurosciences Medical University of South Carolina Charleston, SC, USA
2Department of Health Sciences & Research Medical University of South Carolina Charleston, SC, USA
3Aurora Advanced Health Care 3003 W. Good Hope Rd. Milwaukee, Wisconsin, USA
4Coastal Carolina Medical Associates 1010 Medical Center Drive, Suite 240 Hardeeville, SC, USA
- Corresponding Author:
- Vanessa K. Hinson
Department of Neurosciences Medical
University of South Carolina Charleston, SC, USA
Tel: 843-792-7262
E-mail: hinsonvk@musc.edu
Received date: July 15, 2014; Accepted date: November 12, 2014; Published date: November 19, 2014
Citation: Vanessa KH, Delambo A, Embry AE, Gregory C, Gaines K et al. (2014) Forced Exercise for Freezing of Gait in Post STN DBS Parkinson’s Disease Patients. J Alzheimers Dis Parkinsonism 4:171. doi:10.4172/2161-0460.1000171
Copyright: © 2014 Vanessa K. Hinson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Freezing of gait (FoG) is a debilitating condition experienced by Parkinson’s disease (PD) patients whereby they are episodically unable to walk despite their intention to do so. Early, it may occur in the OFF state, and responds to dopaminergic therapy and deep brain stimulation (DBS). FoG can also occur in the ON state, termed non-levodopa responsive FoG (NLR-FoG). The objective of this study was to determine the effects of a forced exercise treadmill protocol on NLR-FoG in patients with PD that had undergone DBS. We recruited five patients to complete a progressive treadmill-training program for six weeks. The freezing of gait questionnaire (FoG-Q) was the primary outcome measure. Patients also completed diaries documenting the number of freezing episodes and falls, the gait and falls questionnaire (GFQ), as well as PD motor and balance assessments pre and post treatment. Objective assessment of spatiotemporal gait parameters were also collected pre and post treatment. We did not see a significant difference in the FoG-Q pre and post treatment. We did see improvements in the MDS-UPDRS in 4/5 patients, and improvements in falls and freezing as measured by diaries in 3/5 patients. Improvement in spatiotemporal gait parameters beyond the minimal detectible change was seen in 2/5 patients. In conclusion, we found that a progressive forced exercise protocol is feasible in patients with PD post DBS, but response to treatment was not uniform. Further larger studies to elucidate factors predictive of response in this patient population are warranted.