32. Gait, Postural Instability, and Freezing

  1. C. Warren Olanow MD, FRCPC5,6,7,
  2. Fabrizio Stocchi MD, PhD8 and
  3. Anthony E. Lang MD, FRCPC9,10,11
  1. Yvette A. M. Grimbergen MD1,2,
  2. Arlène D. Speelman MSc3,
  3. Marjolein A. van der Marck MSc3,
  4. Yvonne Schoon MD4 and
  5. Bastiaan R. Bloem MD3

Published Online: 27 JUN 2011

DOI: 10.1002/9781444397970.ch32

Parkinson's Disease: Non-Motor and Non-Dopaminergic Features

Parkinson's Disease: Non-Motor and Non-Dopaminergic Features

How to Cite

Grimbergen, Y. A. M., Speelman, A. D., van der Marck, M. A., Schoon, Y. and Bloem, B. R. (2011) Gait, Postural Instability, and Freezing, in Parkinson's Disease: Non-Motor and Non-Dopaminergic Features (eds C. W. Olanow, F. Stocchi and A. E. Lang), Blackwell Publishing Ltd., Oxford, UK. doi: 10.1002/9781444397970.ch32

Editor Information

  1. 5

    Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA

  2. 6

    Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, USA

  3. 7

    Robert and John M. Bendheim Parkinson's Disease Center, Mount Sinai School of Medicine, New York, NY, USA

  4. 8

    Parkinson's Disease and Movement Disorders Research Centre, Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy

  5. 9

    Division of Neurology, University of Toronto, Toronto, ON, Canada

  6. 10

    Parkinson's Disease Research, University of Toronto, Toronto, ON, Canada

  7. 11

    Movement Disorder Centre, Toronto Western Hospital, Toronto, ON, Canada

Author Information

  1. 1

    Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands

  2. 2

    Department of Neurology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands

  3. 3

    Department of Neurology and Parkinson Centre Nijmegen, Donders Institute for Brain Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

  4. 4

    Department of Geriatrics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Publication History

  1. Published Online: 27 JUN 2011
  2. Published Print: 29 JUL 2011

ISBN Information

Print ISBN: 9781405191852

Online ISBN: 9781444397970

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Keywords:

  • falls;
  • gait;
  • postural instability;
  • freezing;
  • non-dopaminergic;
  • intervention;
  • physiotherapy;
  • Parkinson's disease

Summary

Gait, freezing, and balance impairment are common features of Parkinson's disease. Freezing and postural disturbances are typically late manifestations, and probably have a partly non-dopaminergic origin. Timely recognition and careful examination of gait and balance disturbances are important in clinical practice, for various reasons: to support clinicians in refining their differential diagnosis of patients presenting with a hypokinetic-rigid syndrome; for prognostic reasons (because gait and balance impairment are markers for more rapid disease progression and reduced survival); and for the development of an individually tailored treatment program that aims to restore mobility and to prevent falls and other incapacitating consequences. Optimal prevention of falls requires a multifactorial and multidisciplinary program, consisting of both Parkinson-specific and generic measures. This chapter reviews these problems and presents a comprehensive falls prevention program that is ready for evaluation in randomized clinical trials.