Scoring festination and gait freezing in people with Parkinson's: The freezing of gait severity tool-revised

To improve existing clinical assessments for freezing of gait (FOG) severity, a new clinician-rated tool which integrates the varied types of freezing (FOG Severity Tool-Revised) was developed. This cross-sectional study investigated its validity and reliability. People with Parkinson's disease...

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Published in:Physiotherapy research international : the journal for researchers and clinicians in physical therapy 2023-10, Vol.28 (4), p.e2016-e2016
Main Authors: Scully, Aileen E, Tan, Dawn, Oliveira, Beatriz Ito Ramos de, Hill, Keith D, Clark, Ross, Pua, Yong Hao
Format: Article
Language:English
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Summary:To improve existing clinical assessments for freezing of gait (FOG) severity, a new clinician-rated tool which integrates the varied types of freezing (FOG Severity Tool-Revised) was developed. This cross-sectional study investigated its validity and reliability. People with Parkinson's disease who were able to independently ambulate eight-metres and understand study instructions were consecutively recruited from outpatient clinics of a tertiary hospital. Those with co-morbidities severely affecting gait were excluded. Participants were assessed with the FOG Severity Tool-Revised, three functional performance tests, the FOG Questionnaire, and outcomes measuring anxiety, cognition, and disability. The FOG Severity Tool-Revised was repeated for test-retest reliability. Exploratory factor analysis and Cronbach's alpha were computed for structural validity and internal consistency. Reliability and measurement error were estimated with ICC (two-way, random), standard error of measurement, and smallest detectable change (SDC ). Criterion-related and construct validity were calculated with Spearman's correlations. Thirty-nine participants were enrolled [79.5% (n = 31) male; Median (IQR): age-73.0 (9.0) years; disease duration-4.0 (5.8) years], with fifteen (38.5%) who reported no medication state change contributing a second assessment for reliability estimation. The FOG Severity Tool-Revised demonstrated sufficient structural validity and internal consistency (α = 0.89-0.93), and adequate criterion-related validity compared to the FOG Questionnaire (ρ = 0.73, 95% CI 0.54-0.85). Test-retest reliability (ICC = 0.96, 95%CI 0.86-0.99) and random measurement error (%SDC  = 10.4%) was acceptable in this limited sample. The FOG Severity Tool-Revised appeared valid in this initial sample of people with Parkinson's. While its psychometric properties remain to be confirmed in a larger sample, it may be considered for use in the clinical setting.
ISSN:1358-2267
1471-2865
DOI:10.1002/pri.2016