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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.01024

Gait Disorders Questionnaire - Promising Tool for Virtual Reality Designing in Patients with Parkinson´s Disease

  • 12nd Department of Neurology, Faculty of Medicine, Comenius University, Slovakia
  • 2Department of Psychology, Faculty of Arts, Comenius University, Slovakia
  • 3Department of Psychiatry, Faculty of Medicine, Comenius University, Slovakia
  • 4Institute of Normal and Pathological Physiology, Center of Experimental Medicine, Slovak Academy of Sciences (SAS), Slovakia

Background
Gait disorders (GD) are frequent and disabling symptoms in patients with Parkinson´s disease, mostly because they significantly limit mobility and often lead to fear of falls or actual falls. Nowadays rehabilitation is considered to be the most effective nonpharmacological approach to reduce risk of falls. Using paradigms in virtual reality (VR) is a promising tool in neurorehabilitation because of the potential improvement in motor learning and improvement in daily functioning by replicating everyday real-life scenarios.
Objective
To identify the most prevalent everyday situations which impair gait in PD that could be simulated in virtual reality (VR) environment.
Methods
A newly developed self-report questionnaire consisting of 15 binary response items (YES/NO) encompassing everyday walking situations was administered to 62 patients diagnosed with idiopathic PD according to MDS Clinical Diagnostic Criteria. We included patients able to walk unassisted for at least 10 minutes and without significant cognitive impairment. Mokken Scale Analysis was used to evaluate psychometric properties of the scale.
Results
Questionnaires from 58 patients were analysed (31 men, age=63±9.9y, disease duration= 7.02±4.03y, LEDD=1115±549.4mg, H&Y=2.4±0.6). Only 10 items (out of 15) were identified as scalable and these were included in Gait Disorders Questionnaire (GDQ). The most prevalent trigger of gait disorders was walking under time pressure, followed by gait in crowded places and walking while dual-tasking. The total score of GDQ significantly correlated with the disease duration (rs=0.347, p= 0.008) and modified H&Y staging (rs=0.288, p=0.028).
Conclusion
With the use of GDQ we identified the most prevalent everyday transition activities that provoke gait disorders in patients with PD. The results may be useful for further development and systematic application of VR paradigms for physiotherapy of PD patients.

Keywords: Parkinson´s disease (PD), Gait, freezing of gait, virtual reality, Neurorehabilitation

Received: 07 May 2019; Accepted: 09 Sep 2019.

Copyright: © 2019 Kosutzka, Kusnirova, Hajduk, Straka, Minar and Valkovič. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Peter Valkovič, 2nd Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, 833 05, Slovakia, peter.valkovic@gmail.com