Journal article
Time To Navigate (TTN): A practical objective clinical measure for freezing of gait severity in people with Parkinson's disease
Archives of Physical Medicine and Rehabilitation, Vol.106(2), pp.247-254
2025
Abstract
Objectives
To provide an easy-to-use measure, as existing objective assessments for freezing of gait (FOG) severity may be unwieldy for routine clinical practice, this study explored time taken to complete the recently-validated FOG Severity Tool and its components.
Design
Cross-sectional
Setting
Outpatient clinics of a tertiary hospital
Participants
People with Parkinson's who could independently ambulate eight-metres, understand instructions, and without co-morbidities affecting gait were consecutively recruited. Thirty-five participants were included [82.9%(n=29)male; Median(IQR): age – 73.0(11.0)years; disease duration – 4.0(4.5)years].
Interventions
Not applicable
Main outcome measures
Participants were assessed with FOG Severity Tool in a test-retest design, with time taken for each component recorded using a stopwatch during video-analysis. Validity of total FOG Severity Tool time, time taken to complete its turning and narrow-space components (i.e., Time To Navigate, TTN), and an adjusted-TTN were examined through correlations with validated FOG severity outcomes. To facilitate clinical interpretation, TTN cutoff was determined using scatterplot smoothing (LOESS) regression whilst minimal important change (MIC) was calculated using predictive modelling.
Results
FOG Severity Tool time, TTN, and adjusted-TTN similarly demonstrated moderate correlations with the FOG Questionnaire and percentage-FOG, and very-high correlations with FOG Severity Tool-Revised. TTN was nonlinearly related to FOG severity, with a positive relationship observed in the first 300-seconds and plateauing after. MIC for TTN was 15.4-seconds reduction in timing (95%CI 3.2 to 28.7).
Conclusions
TTN is a feasible, interpretable, and valid test of FOG severity. In busy clinical settings, TTN can provide a viable alternative when use of existing objective FOG measures is (often) unfeasible.
Details
- Title
- Time To Navigate (TTN): A practical objective clinical measure for freezing of gait severity in people with Parkinson's disease
- Authors
- Aileen Eugenia Scully (Corresponding Author) - Singapore Institute of TechnologyDawn May Leng Tan (Author) - Singapore Institute of TechnologyBeatriz Ito Ramos de Oliveira (Author) - Curtin UniversityKeith David Hill (Author) - Monash UniversityRoss Clark (Author) - University of the Sunshine Coast, Queensland, School of Health - Sports & Exercise ScienceYong Hao Pua (Author) - Singapore General Hospital
- Publication details
- Archives of Physical Medicine and Rehabilitation, Vol.106(2), pp.247-254
- Publisher
- Elsevier Inc.
- Date published
- 2025
- DOI
- 10.1016/j.apmr.2024.09.003
- ISSN
- 1532-821X
- Grant note
- The Mitsui Sumitomo Insurance Welfare Foundation Research Grant 2020 funded the original study, which produced data used in this study.
- Organisation Unit
- School of Health - Sports & Exercise Science; Healthy Ageing Research Cluster
- Language
- English
- Record Identifier
- 991065006902621
- Output Type
- Journal article
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