Falls and freezing of gait in Parkinson’s disease: a review of two interconnected, episodic phenomena
Bloem BR, Hausdorff JM, Visser JE, Giladi N. (2004 Aug) Falls and freezing of gait in Parkinson’s disease: a review of two interconnected, episodic phenomena , 19(8):871-84
This article reviewed falls and freezing of gait (e.g. feeling that one’s feet are glued to the ﬂoor) in patients with PD. Patients usually experience falls later in the course of the PD and almost all patients will have one fall (approximately 70%) or recurrent falls (~50%) during their disease course, more so than age-matched controls (30%). Freezing of gait is also a "late" feature of PD, but a much higher percentage (40-80%) of patients with PD never experience this symptom. Both falls and freezing of gait can have negative effects on patient health as well as quality of life. Falls can cause joint dislocations, bruises, and hip fractures, which are associated with a higher mortality (death) rate and nursing home admission among patients. Patients may also experience a loss of mobility that contributes to osteoarthritis, which increases the likelihood of fractures after a fall. These authors also review the appropriate clinical assessment by physicians, physiology, and treatment of falls and freezing of gait. They discuss that bilateral deep brain surgeries (pallidal and subthalamic nucleus) and physical therapy have been shown to improve walking, posture, and freezing of gait during the "off" state of patients with PD.