Objective: To develop a testing and recording system that can reliably increase the rate of diagnosing freezing of gait (FOG) in patients living with Parkinson’s disease (PD) during clinic visits without medication suspension (“On-meds” FOG).

Background: FOG is a brief episode of failed locomotion despite “the intention to walk”. Over 40% PD patients can experience “On-meds” FOGs, particularly during body transfer (e.g. turning), multi-tasking and/or cognitive overloading. Hence, “On-meds” FOGs pose significant risks of fall and injury during daily activities and impact quality of life.

Method: We recruited 50 self-reported PD freezers who maintained their regular medication regime during clinic visits. Patients underwent a composite timed up and go (cTUG) test for FOG induction, which consisted of one standard TUG (sTUG) and one cognitive (cTUG) and one manual (mTUG), each conducted in random order. The tests lasted 3 minutes. We used Ambulosono single sensor and App for FOG recording and visualization.

Results: cTUGs induced at least one episode of FOG for each patient, yielding a FOG induction ratio of 2.14 episodes/patient. There was a 3.9 fold increase in FOG episodes under dual task conditions (cTUG and mTUG) than the sTUGs. Trembling, shuffling and akinesia are the main subtypes of FOGs that occurred during different phases of a TUG test. FOG episodes recorded via wearable sensor and hand-held devices permitted real time visualization and diagnosis of different FOG subtypes with a sensitivity of 87.2% and specificity of 89.5%, respectively.

Conclusion: “On-meds” FOGs can be reliably diagnosed in a clinical setting via cognitive-motor testing and wearable device recording. This combination may provide a valuable tool for expediting clinical exam and diagnosis of “On-meds” FOGs.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-motor-tests-markedly-increase-the-diagnostic-rate-of-on-meds-freezing-of-gait-in-parkinsons-disease-during-clinical-visits/