Subscribe to RSS
Download PDF
DOI: 10.1055/s-0038-1628855
Diagnose und Therapie von Festination und Freezing
Diagnostic assessment and therapeutic approach to festination and freezingPublication History
Eingegangen am:
06 September 2010
angenommen am:
06 September 2010
Publication Date:
31 January 2018 (online)
Zusammenfassung
Motorische Blockaden während des Gehens sind als eine episodisch auftretende Störung der Ganginitiierung und des Lokomotionserhalts bei Parkinsonsyndromen und zentralen Gangstörungen definiert. Phänomenologisch werden Festination, trembling-in-place und total akinesia als Freezing-Formen unterschieden. Fünf differente Gangsituationen wurden als klassische Provokatoren für Freezing-Episoden benannt. Um eine Testung durch einen Beobachter klinisch einfach und aussagekräftig durchführen zu können, haben wir ein neues Testinstrument, den Freezing-ofgait-Score (FOG-Score) entwickelt, der im klinischen Alltag erprobt wird. Freezing bei Parkinsonpatienten ist meist dopasensitiv, kann aber auch im On-Zustand des Patienten auftreten und ist dann schwer zu therapieren.Wir diskutieren standardisierte Therapieschemata für Patienten mit On-Freezing, die wir an unserem Zentrum entwickelt haben.
Summary
Motor blocks during walking are defined as sudden episodic inabilities to initiate or sustain locomotion in Parkinson’s disease (PD) or other higher-level gait disorders. Phenomenologically festination is differentiated from trembling-in-place and from total akinesia. Five situations have been described as classical provoking environments. In order to clinically assess freezing with short-term time intervals we have developed a new scoring instrument that is currently further validated. Freezing is dopa-sensitive in most PD patients, however, it can occur during On-medication states, and then is difficult to treat. We report on physiotherapeutical approaches to overcome and reduce On-freezing by standarized treatment approaches.
-
Literatur
- 1 Morris ME, Iansek R, Galna B. Gait festination and freezing in Parkinson’s disease: pathogenesis and rehabilitation. Mov Disord 2008; 23 Suppl 2: S451-60.
- 2 Giladi N, Nieuwboer A. Understanding and treating freezing of gait in parkinsonism, proposed working definition, and setting the stage. Mov Disord 2008; 23 Suppl 2: S423-5.
- 3 Thompson PD, Marsden CD. Walking disorders. In: Bradley DG, Daroff RB, Fenichel GM, Marsden CD. (eds.). Neurology in clinical practice – Principles of diagnosis and management. Boston: Butterworth-Heinemann; 1995
- 4 Fahn S. The freezing phenomenon in parkinsonism. Adv Neurol 1995; 67: 53-63.
- 5 Rahman S. et al. The factors that induce or overcome freezing of gait in Parkinson’s disease. Behav Neurol 2008; 19 (03) 127-36.
- 6 Giladi N. et al. Motor blocks in Parkinson’s disease. Neurology 1992; 42 (02) 333-9.
- 7 Bartels AL. et al. Relationship between freezing of gait (FOG) and other features of Parkinson’s: FOG is not correlated with bradykinesia. J Clin Neurosci 2003; 10 (05) 584-8.
- 8 Bloem BR. et al. Falls and freezing of gait in Parkinson’s disease: a review of two interconnected, episodic phenomena. Mov Disord 2004; 19 (08) 871-84.
- 9 Nieuwboer A, Giladi N. The challenge of evaluating freezing of gait in patients with Parkinson’s disease. Br J Neurosurg 2008; 22 Suppl 1: S16-8.
- 10 Plotnik M, Giladi N, Hausdorff JM. Bilateral coordination of walking and freezing of gait in Parkinson’s disease. Eur J Neurosci 2008; 27 (08) 1999-2006.
- 11 Hashimoto T. Speculation on the responsible sites and pathophysiology of freezing of gait. Parkinsonism Relat Disord 2006; 12: 55-62.
- 12 Macht M. et al. Predictors of freezing in Parkinson’s disease: a survey of 6,620 patients. Mov Disord 2007; 22 (07) 953-6.
- 13 Giladi N. Freezing of gait. Clinical overview. Adv Neurol 2001; 87: 191-7.
- 14 Schaafsma JD. et al. Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson’s disease. Eur J Neurol 2003; 10 (04) 391-8.
- 15 Rochester L. et al. The attentional cost of external rhythmical cues and their impact on gait in Parkinson’s disease: effect of cue modality and task complexity. J Neural Transm 2007; 114 (10) 1243-8.
- 16 Okuma Y, Yanagisawa N. The clinical spectrum of freezing of gait in Parkinson’s disease. Mov Disord 2008; 23 Suppl 2: S426-30.
- 17 Moore O, Peretz C, Giladi N. Freezing of gait affects quality of life of peoples with Parkinson’s disease beyond its relationships with mobility and gait. Mov Disord 2007; 22 (15) 2192-5.
- 18 Latt MD. et al. Clinical and physiological assessments for elucidating falls risk in Parkinson’s disease. Mov Disord 2009; 24 (09) 1280-9.
- 19 Michalowska M. et al. Falls in Parkinson’s disease. Causes and impact on patients’ quality of life. Funct Neurol 2005; 20 (04) 163-8.
- 20 Giladi N. et al. Construction of freezing of gait questionnaire for patients with Parkinsonism. Parkinsonism Relat Disord 2000; 06 (03) 165-170.
- 21 Keus SH. et al. Clinimetric analyses of the Modified Parkinson Activity Scale. Parkinsonism Relat Disord 2009; 15 (04) 263-9.
- 22 Snijders AH. et al. Clinimetrics of freezing of gait. Mov Disord 2008; 23 Suppl 2: S468-74.
- 23 Nieuwboer A. et al. Abnormalities of the spatiotemporal characteristics of gait at the onset of freezing in Parkinson’s disease. Mov Disord 2001; 16 (06) 1066-75.
- 24 Ziegler K. et al. A new rating instrument to assess festination and freezing gait in Parkinsonian patients. Mov Disord. 2010 online ahead of print.
- 25 Giladi N. Medical treatment of freezing of gait. Mov Disord 2008; 23 Suppl 2: S482-8.
- 26 Ferraye MU, Debu B, Pollak P. Deep brain stimulation effect on freezing of gait. Mov Disord 2008; 23 Suppl 2: S489-94.
- 27 Muller V. et al. Short-term effects of behavioral treatment on movement initiation and postural control in Parkinson’s disease: a controlled clinical study. Mov Disord 1997; 12 (03) 306-14.
- 28 Keus SH. et al. Evidence-based analysis of physical therapy in Parkinson’s disease with recommendations for practice and research. Mov Disord 2007; 22 (04) 451-60.
- 29 Azulay JP. et al. Visual control of locomotion in Parkinson’s disease. Brain 1999; 122 (Pt 1): 111-20.
- 30 Rossignol S, Jones GM. Audio-spinal influence in man studied by the H-reflex and its possible role on rhythmic movements synchronized to sound. Electroencephalogr Clin Neurophysiol 1976; 41 (01) 83-92.
- 31 Schroeteler F. et al. [Freezing of gait : phenomenology, pathophysiology, and therapeutic approaches]. Nervenarzt 2009; 80 (06) 693-9.
- 32 Suteerawattananon M. et al. Effects of visual and auditory cues on gait in individuals with Parkinson’s disease. J Neurol Sci 2004; 219 (1–2): 63-9.
- 33 Frazzitta G. et al. Rehabilitation treatment of gait in patients with Parkinson’s disease with freezing: a comparison between two physical therapy protocols using visual and auditory cues with or without treadmill training. Mov Disord 2009; 24 (08) 1139-43.
- 34 Hong M, Earhart GM. Rotating treadmill training reduces freezing in Parkinson disease: preliminary observations. Parkinsonism Relat Disord 2008; 14 (04) 359-63.
- 35 Nieuwboer A. et al. Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial. J Neurol Neurosurg Psychiatry 2007; 78 (02) 134-40.
- 36 Cubo E, Leurgans S, Goetz CG. Short-term and practice effects of metronome pacing in Parkinson’s disease patients with gait freezing while in the ‘on’ state: randomized single blind evaluation. Parkinsonism Relat Disord 2004; 10 (08) 507-10.
- 37 Dietz MA, Goetz CG, Stebbins GT. Evaluation of a modified inverted walking stick as a treatment for parkinsonian freezing episodes. Mov Disord 1990; 05 (03) 243-7.
- 38 Jiang Y, Norman KE. Effects of visual and auditory cues on gait initiation in people with Parkinson’s disease. Clin Rehabil 2006; 20 (01) 36-45.
- 39 Willems AM. et al. The use of rhythmic auditory cues to influence gait in patients with Parkinson’s disease, the differential effect for freezers and nonfreezers, an explorative study. Disabil Rehabil 2006; 28 (11) 721-8.
- 40 Brichetto G. et al. Evaluation of physical therapy in parkinsonian patients with freezing of gait: a pilot study. Clin Rehabil 2006; 20 (01) 31-5.