Objective measures to investigate turning impairments and freezing of gait in people with Parkinson's disease

Matilde Bertoli, Ugo Della Croce, Andrea Cereatti, Martina Mancini

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Turning is impaired in people with Parkinson's Disease (PD) and it is a common trigger for freezing of gait (FoG). Recent evidence suggests that people with PD who freeze (PD+FoG) have worse turning performance than those who don't have freezing (non-freezers, PD-FoG), and the freezing episodes are exacerbated by increasing the turn angular amplitude. Research question: We investigated the difference between turning 180° while walking versus turning 360° in place, in both single- and dual-task conditions, by means of objective measures in people with PD with and without FoG. Methods: Twenty-four PD+FoG and eighteen PD-FoG performed 180° turns while walking and 360° turns in place during single- and dual-task conditions. Quantitative measures of turning and the dual-task cost were computed. Differences were investigated between groups and within turning types using ANOVA. Associations between turn measures and clinical scales were examined with Spearman correlations. Results: Turn duration and the number of steps were greater, and peak angular velocity slower, in PD+FoG compared to PD-FoG (p < 0.001). Dual-task costs were similar across groups, but turn duration showed significant interaction (p = 0.03). Posture Instability and Gait Disability (PIGD) subscore was associated with all turn measures in PD-FoG; whereas PIGD was mainly associated with turning while walking in PD+FoG. Significance: Objective measures of turning revealed differences between people with and without FoG, specifically, people with FoG showed more impairments in 360° turning in place compared to 180° turning while walking. However, as the turning challenges were increased by adding a dual-task, results from PD+FoG were similar to those from PD-FoG.

Original languageEnglish (US)
Pages (from-to)187-193
Number of pages7
JournalGait and Posture
StatePublished - Oct 2019


  • Dual-task
  • Freezing of gait
  • Inertial measurement unit
  • Parkinson's disease
  • Turning

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation


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