Introduction. The effectiveness of the currently utilized therapies for FoG is limited. Several studies demonstrated a beneficial impact of Nordic walking (NW) on several gait parameters in Parkinson’s disease, but only one paper reported reduction of freezing. Research Question. In the present study, the question is whether NW is an effective therapeutic intervention in FoG. Methods. Twenty PD subjects trained NW for 12 weeks, with a frequency of twice per week. Each session lasted about 60 minutes. Twenty patients in the control group did not use any form of physiotherapy (no-intervention group). Freezing of Gait Questionnaire (FOGQ), the Timed Up and Go (TUG) test, and the Provocative Test for Freezing and Motor Blocks (PTFMB) were performed at baseline, immediately after the end of NW program, and three months later. Results. The results of FOGQ, TUG, and total PTFMB revealed significant improvement after completing the exercise program, and this effect persisted at follow-up. The results of the PTFMB subtests showed a different effect of NW on particular subtypes of FoG. Start hesitation, sudden transient blocks that interrupt gait, and blocks on turning improved considerably, while motor blocks, when walking through narrow space and on reaching the target, did not respond to NW training. Significance. The results show, for the first time, that FoG during turning and step initiation, two most common forms of this gait disorder, has been significantly reduced by NW training. Different responses of particular subtypes of FoG to NW probably reflect their different pathophysiologies. Conclusions. The present study showed that NW training had a beneficial effect on FOG in PD and that the achieved improvement is long-lasting. Future research should clarify whether the observed improvement limited to FoG triggered by only some circumstances reflects different pathomechanisms of FoG subtypes.

中文翻译：

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越野行走对帕金森病步态冻结的治疗效果：一项初步研究。

简介。目前使用的 FoG 疗法的有效性是有限的。几项研究表明，北欧式步行 (NW) 对帕金森病的几个步态参数有有益的影响，但只有一篇论文报道了冻结的减少。研究问题。在本研究中，问题是 NW 是否是 FoG 的有效治疗干预。方法. 20 名 PD 受试者接受了为期 12 周的 NW 训练，频率为每周两次。每节课持续约60分钟。对照组中的 20 名患者未使用任何形式的物理治疗（无干预组）。冻结步态问卷 (FOGQ)、Timed Up and Go (TUG) 测试以及冻结和运动阻滞刺激性测试 (PTFMB) 在基线时、NW 计划结束后立即和三个月后进行。结果. FOGQ、TUG 和总 PTFMB 的结果显示完成锻炼计划后有显着改善，并且这种效果在随访中持续存在。PTFMB 子测试的结果显示了 NW 对特定 FoG 亚型的不同影响。开始犹豫、中断步态的突然瞬时阻滞和转弯阻滞显着改善，而运动阻滞在穿过狭窄空间并到达目标时对 NW 训练没有反应。意义。结果首次表明，NW 训练显着减少了转弯和踏步开始时的 FoG，这是这种步态障碍的两种最常见形式。FoG 的特定亚型对 NW 的不同反应可能反映了它们不同的病理生理学。结论. 本研究表明，NW 训练对 PD 患者的 FOG 产生了有益的影响，并且所取得的改善是持久的。未来的研究应阐明观察到的仅限于仅由某些情况触发的 FoG 的改善是否反映了 FoG 亚型的不同病理机制。