Cognitive contributions to freezing of gait in parkinson disease: Implications for physical rehabilitation

Daniel S. Peterson, Laurie A. King, Rajal G. Cohen, Fay B. Horak

    Research output: Contribution to journalArticle

    39 Scopus citations

    Abstract

    People with Parkinson disease (PD) who show freezing of gait also have dysfunction in cognitive domains that interact with mobility. Specifically, freezing of gait is associated with executive dysfunction involving response inhibition, divided attention or switching attention, and visuospatial function. The neural control impairments leading to freezing of gait have recently been attributed to higher-level, executive and attentional cortical processes involved in coordinating posture and gait rather than to lower-level, sensorimotor impairments. To date, rehabilitation for freezing of gait primarily has focused on compensatory mobility training to overcome freezing events, such as sensory cueing and voluntary step planning. Recently, a few interventions have focused on restitutive, rather than compensatory, therapy. Given the documented impairments in executive function specific to patients with PD who freeze and increasing evidence of overlap between cognitive and motor function, incorporating cognitive challenges with mobility training may have important benefits for patients with freezing of gait. Thus, a novel theoretical framework is proposed for exercise interventions that jointly address both the specific cognitive and mobility challenges of people with PD who freeze.

    Original languageEnglish (US)
    Pages (from-to)659-670
    Number of pages12
    JournalPhysical Therapy
    Volume96
    Issue number5
    DOIs
    StatePublished - May 2016

    ASJC Scopus subject areas

    • Physical Therapy, Sports Therapy and Rehabilitation

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