Walking patterns in Parkinson's disease with and without freezing of gait

W Nanhoe-Mahabier, A.H. Snijders, A Delval, V Weerdesteyn, J Duysens, S Overeem, B R Bloem

Research output: Contribution to journalArticleAcademicpeer-review

74 Citations (Scopus)


The pathophysiology underlying freezing of gait (FOG) in Parkinson's disease remains incompletely understood. Patients with FOG ("freezers") have a higher temporal variability and asymmetry of strides compared to patients without FOG ("non-freezers"). We aimed to extend this view, by assessing spatial variability and asymmetry of steps and interlimb coordination between the upper and lower limbs during gait. Twelve freezers, 15 non-freezers, and 15 age-matched controls were instructed to walk overground and on a treadmill. Kinematic data were recorded with a motion analysis system. Both freezers and non-freezers showed an increased spatial variability of leg movements compared to controls. In addition, both patient groups had a deficit in interlimb coordination, not only between ipsilateral arms and legs, but also between diagonally positioned limbs. The only difference between freezers and non-freezers was a decreased step length during treadmill walking. We conclude that parkinsonian gait-regardless of FOG-is irregular, not only in the legs, but also with respect to interlimb coordination between the arms and legs. FOG is reflected by abnormal treadmill walking, presumably because this provides a greater challenge to the defective supraspinal control than overground walking, hampering the ability of freezers to increase their stride length when necessary.

Original languageEnglish
Pages (from-to)217-24
Number of pages8
Publication statusPublished - 19 May 2011
Externally publishedYes


  • Aged
  • Disability Evaluation
  • Exercise Test
  • Female
  • Gait
  • Gait Disorders, Neurologic
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease
  • Walking
  • Comparative Study
  • Journal Article
  • Research Support, Non-U.S. Gov't


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