Objective: To evaluate the validity and reliability of the Thai version of FOG-Q (Thai FOG-Q) in individuals with PD.

Background: Freezing of gait (FOG) is a common feature in late-stage PD. PD patients with FOG (freezers) have a higher risk of falling than those without FOG [1]. Seventy-five percent of freezers have reported experiencing the symptom at home [2]; this might not correlate with the observed FOG at the clinic. The FOG-Q, constructed by Giladi et al., is a recommended tool to evaluate FOG frequency and severity due to its reliability and validity in assessing the treatment effect of FOG in PD patients [3-4]. The FOG-Q is practical and has no floor or ceiling effects. It has been translated into various languages.

Method: This was a descriptive study. The FOG-Q was translated into Thai in accordance with the translation and cross-cultural adaptation of measurements [5]. Content validity index (CVI) was used to assess content validity. Fifty-six patients with PD participated in the study. Convergent validity was assessed by correlating the Thai FOG-Q with the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) item 2.13 and 3.11, the Falls Efficacy Scale-International (FES-I) and the Timed Up and Go Test (TUG) using Spearman’s correlation coefficient (rS). Divergent validity was assessed by correlating the Thai FOG-Q with Berg Balance Scale (BBS). We evaluated the correlation between the Thai FOG-Q and the clinical characteristics, including modified Hoehn and Yahr stage (mH&Y). Internal consistency and test-retest reliability were evaluated with Cronbach’s alpha (C_α) and Intraclass correlation coefficient (ICC), respectively.

Results: The Thai FOG-Q showed high content validity (CVI = 0.96). The mean score was 9.0+4.9. It had a significant positive strong correlation with the MDS-UPDRS item 2.13 (rs= 0.81), and moderate correlations with MDS-UPDRS item 3.11, FES-I, and TUG (rs= 0.42-0.60). BBS negatively correlated with FOG-Q (rs= -0.32). The Thai FOG-Q also had a significant moderate correlation with mH&Y. A good internal consistency of the FOG-Q was found (Cα = 0.87) with an excellent test-retest reliability (ICC = 0.91).

Conclusion: The Thai FOG-Q has excellent reliability and validity. It is a useful instrument for the evaluation of FOG in PD patients.

References: 1. Georgy E. Freezing of Gait in Parkinson’s Disease: Impact on Falls Risk, Walking Aids Utilization, and Assistance-Seeking Behaviour. Eur J Adapt Phys Act. 2010;3(1):49–59.
2. Giladi N, Shabtai H, Simon ES, Biran S, Tal J, Korczyn AD. Construction of freezing of gait questionnaire for patients with Parkinsonism. Park Relat Disord. 2000;6(3):165–70.
3. Bloem BR, Marinus J, Almeida Q, Dibble L, Nieuwboer A, Post B, et al. Measurement instruments to assess posture, gait, and balance in Parkinson’s disease: Critique and recommendations. Mov Disord. 2016;31(9):1342–55.
4. Giladi N, Tal J, Azulay T, Rascol O, Brooks DJ, Melamed E, et al. Validation of the Freezing of Gait Questionnaire in patients with Parkinson’s disease. Mov Disord. 2009;24(5):655–61.
5. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. SPINE. 2000;25(24):3186–3191

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MDS Abstracts - https://www.mdsabstracts.org/abstract/validity-and-reliability-of-the-thai-version-of-the-freezing-of-gait-questionnaire-fog-q-in-individuals-with-parkinsons-disease-pd/