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Preprint
Time To Navigate (TTN): A practical objective clinical measure for freezing of gait severity in people with Parkinson's disease
medRxiv , Vol.20 August 2023
Cold Spring Harbor Laboratory Press
2023
Abstract
Objectives: Existing objective assessments for freezing of gait (FOG) severity may be unwieldy for routine clinical practice. To provide an easy-to-use clinical measure, this cross-sectional study explored if time to complete the recently-validated FOG Severity Tool (or its components) could be used to reflect FOG severity.
Methods: People with Parkinson’s disease who could independently ambulate eight-metres, understand instructions, and without co-morbidities severely affecting gait were consecutively recruited from outpatient clinics. Participants were assessed with the 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 the FOG Questionnaire, percentage of time spent with FOG, and FOG Severity Tool-Revised score. To facilitate clinical interpretation, TTN cutoff was determined using scatterplot smoothing (LOESS) regression whilst minimal important change (MIC) was calculated using predictive modelling.
Results: 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]. The 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 such that a positive relationship was observed in the first 300-seconds, beyond which the association plateaued. MIC for TTN was 15.4-seconds reduction in timing (95%CI 3.2 to 28.7).
Conclusions: The TTN is a feasible, interpretable, and valid test of FOG severity, demonstrating strong convergent validity with the FOG Severity Tool-Revised. In busy clinical settings, TTN provides a viable alternative when use of existing objective FOG measures is (often) unfeasible.
Impact statement: Busy clinicians need easy-to-use measures. In under 300-seconds, TTN test offers this for FOG severity, with a 15.4-seconds decrease in TTN time considered minimal improvement.
Details
- Title
- Time To Navigate (TTN): A practical objective clinical measure for freezing of gait severity in people with Parkinson's disease
- Authors
- Aileen Scully (Corresponding Author) - Curtin UniversityDawn Tan - Singapore General HospitalBeatriz I R de Oliveira - Curtin UniversityKeith D Hill - Monash UniversityRoss Allan Clark - University of the Sunshine Coast, Queensland, School of Health - Sports & Exercise ScienceYong Hao Pua - Singapore General Hospital
- Publication details
- medRxiv , Vol.20 August 2023
- Publisher
- Cold Spring Harbor Laboratory Press
- Date published
- 2023
- DOI
- 10.1101/2023.08.18.23294294
- Copyright note
- The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
- 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
- Language
- English
- Record Identifier
- 991085097502621
- Output Type
- Preprint
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