A scientific article published late last year (Zhang et al, 2021) highlighted that freezing of gait (in English, Freezing of Gait or FOG) is a more recurrent symptom than one might imagine. In fact, according to Zhang and colleagues' study, more than half of Parkinson's Disease patients suffer from this gait disorder, with major repercussions on multiple spheres of personal and social life. Freezing of Gait is an episodic symptom, meaning that, all of a sudden, the patient can no longer move forward in walking, despite trying to do so with all his or her will. People who have experienced this symptom relate that the sensation is that of having their feet stuck to the floor, as if there were a layer of glue holding them in place. An episode of Freezing typically lasts a few seconds and can be triggered by some particular situation such as walking through a door or moving from one type of floor to another. Starting to walk or turning on oneself (or around an obstacle) are also situations that can trigger a Freezing episode, while factors such as stress and anxiety can undoubtedly worsen its severity. In general, patients suffering from Freezing of Gait experience with difficulty all those situations in which they are under pressure or are forced to deal with sudden changes in the pattern of their gait.
Freezing episodes of walking contribute significantly to increased risk of falling in people with Parkinson's Disease. It is estimated that about 70% of patients with Freezing report at least one fall per year, with consequences (sometimes serious) for medium- and long-term mobility (Wood et al, 2002). The typical dynamic of a Freezing episode involves a sudden halt in walking, with the feet stopping altogether or moving rapidly but without lifting completely off the ground while the patient's torso is brought forward in an attempt to unblock the step. It is precisely this set of actions that causes a progressive loss of balance that can sometimes result in a bad fall. Intervening on the symptoms associated with Freezing of Gait is by no means simple as they do not always respond to pharmacological and surgical therapies (Levodopa and DBS implants, respectively) typically employed in the treatment of Parkinson's Disease. An interesting finding in this regard concerns the frequency with which some patients (about 50%) report having Freezing episodes even under drug coverage (ON-Freezing), when other symptoms of the condition are generally minimized (Perez-Lloret et al, 2014).
Non-invasive approaches such as Gondola AMPS (from the English Automated Mechanical Peripheral Stimulation) therapy can be combined with traditional physical rehabilitation treatment plans for the purpose of improving the Parkinsonian patient's balance and stability even in the presence of recurrent episodes of Freezing of Gait. In fact, among the documented clinical benefits of Gondola AMPS therapy we find a significant improvement in gait capacity that quantitatively translates into increased walking speed and stride length, decreased gait variability, and improved body rotation during movement.
REFERENCES
Perez-Lloret S, Negre-Pages L, Damier P, et al. Prevalence, Determinants, and Effect on Quality of Life of Freezing of Gait in Parkinson Disease. JAMA Neurol. 2014;71(7):884–890. doi:10.1001/jamaneurol.2014.753
Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry. 2002 Jun;72(6):721-5. doi: 10.1136/jnnp.72.6.721. PMID: 12023412; PMCID: PMC1737913.
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