Paradoxical gait at a narrowed entrance in a patient with Hoehn-Yahr stage III Parkinson's disease.
Recently, we studied fallers and non-fallers with Hoehn-Yahr stage III Parkinson's disease (PD) using a path that suddenly narrowed, which we originally designed and produced. A risk of future falls was suggested to be related to slow gait with freezing (SGF) elicited by a fear of falling before arrival at a narrowed entrance or while walking on a narrow path, as well as to the Unified Parkinson's Disease Rating Scale part II score, associated with SGF. In the same study, we had faller patients walk on a path that narrowed in a straight-line fashion to determine whether SGF could be improved. In one patient, who showed a unique paradoxical gait, SGF resolved. We describe this patient in the hope that our experience will provide potential clues to effective ways to prevent future falls in patients with Hoehn-Yahr stage III PD. To prevent gait instability elicited by fear of falling in patients with Hoehn-Yahr stage III PD, it might be useful to remove narrowed entrances.
Department of Neurology, Nara Medical University, Kashihara, Japan. hk55@maramed-u.ac.jp
Hiroshi
H
Kataoka
Noriyuki
N
Tanaka
Takao
T
Kiriyama
Nobuyuki
N
Eura
Hirosei
H
Horikawa
Yoshito
Y
Ikada
Satoshi
S
Ueno
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D005239:Fear / Q000502:physiology; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006801:Humans; D009460:Neurologic Examination / Q000379:methods; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D012306:Risk; D012720:Severity of Illness Index