ABSTRACT
PURPOSE: The Freezing of Gait Severity Tool (FOG Tool) was developed because of limitations in existing assessments. This cross-sectional study investigated its validity and reliability. METHODS: People with Parkinson's disease (PD) were recruited consecutively from clinics. Those who could not walk eight-metres independently (with or without an assistive device), comprehend instructions, or with co-morbidities affecting walking were excluded. Participants completed a set of assessments including the FOG Tool, Timed Up and Go (TUG), and Freezing of Gait Questionnaire. The FOG Tool was repeated and those reporting no medication state change evaluated for test-retest reliability. Validity and reliability were investigated through Spearman's correlations and ICC (two-way, random). McNemar's test was applied to compare the FOG Tool and TUG on the proportion of people with freezing. RESULTS: Thirty-nine participants were recruited [79.5%(n = 31) male; Median(IQR): age-73.0(9.0) years; disease duration-4.0(5.8) years]. Fifteen (38.5%) contributed to test-retest reliability analyses. The FOG Tool demonstrated strongest associations with the Freezing of Gait Questionnaire (ρ = 0.67, 95%CI 0.43-0.83). Test-retest reliability was excellent (ICC = 0.96, 95%CI 0.88-0.99). The FOG Tool had 6.2 times the odds (95%CI 2.4-20.4, p < 0.001) of triggering freezing compared to the TUG. CONCLUSIONS: The FOG Tool appeared adequately valid and reliable in this small sample of people with PD. It was more successful in triggering freezing than the TUG.Implications for RehabilitationThe Freezing of Gait Severity Tool's assessment course is more effective than the commonly-used Timed Up and Go's assessment course for eliciting freezing of gait for clinical evaluation in people with Parkinson's disease.The Freezing of Gait Severity Tool can be considered for scoring freezing of gait severity in people with Parkinson's disease in the clinical setting.
ABSTRACT
OBJECTIVE: To synthesize the evidence regarding the diagnostic value of simple ancillary tests post cerebrospinal fluid drainage in normal pressure hydrocephalus. DATA SOURCES: MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science, and Cochrane library databases; last searched on 12 September 2017. REVIEW METHODS: This review was performed applying the steps of the PRISMA statement. The QUADAS 2 tool was used to assess the risk of bias. Prospective and retrospective trials were systematically reviewed, and data on diagnostic accuracy were extracted. Meta-analysis (where possible) was performed. Hierarchical summary receiver operating characteristic package was used to calculate pooled estimates of included diagnostic studies. RESULTS: Seventeen trials (with 812 subjects in total) were identified for inclusion in the meta-analyses for the 18-meter walk test, video-recorded gait performance, cognitive test, and Timed Up and Go Test. The summary estimates of sensitivity and specificity for the 18-meter walk test was 0.83 (95% CI 0.57 to 0.99) and 0.67 (95% CI 0.33 to 0.95), video-recorded gait performance was 0.85 (95% CI 0.47 to 0.99) and 0.68 (95% CI 0.33 to 0.96), cognitive test was 0.82 (95% CI 0.41-0.99) and 0.75 (95% CI 0.39-0.99), and Timed Up and Go Test was 0.89 (95% CI 0.79-0.95) and 0.63 (95% CI 0.24-0.90), respectively. CONCLUSION: This review highlights the diagnostic value of the 18-meter walk test, video-recorded gait performance, cognitive test, and Timed Up and Go Test in predicting shunt outcomes among adults with normal pressure hydrocephalus.
