Sol De Jesus, Bilal Ahmed, Leonardo Almeida, Leili Shahgholi Ghahfarokhi, Addie Patterson, Lisa Warren, Heather Simpson, Michael Okun and Christopher Hess published in the May 18, 2016 edition of Neurology!
Objective: The purpose of the current study was to ascertain the prevalence of upper extremity freezing in PD.Background: Motor blocks are defined as an inability or delay in initiating/continuing a voluntary movement. Freezing of gait (FOG), a type of motor block, has been established as one of the most debilitating symptoms in Parkinson Disease (PD). The prevalence of FOG in advanced PD has been estimated at 50%. Methods: This retrospective study assesses the rate of upper extremity freezing (UEF) in patients with PD who were evaluated by occupational therapy (OT) at the UF Center for Movement Disorders (August 2014-November 2014). The inclusion criteria required a diagnosis of idiopathic PD without dementia. UEF was assessed via patient self-report spontaneously and an OT functional ADL questionnaire. We described continuous variables by means and nominal variables by counts and percentages. We utilized t-test and ANOVA to compare means, Chi-square for proportions, assuming p < 0.05 for statistical significance. Results: There were 77 men and 46 women in the study. The mean age of the cohort was 68.8±8.9 years. In a 3 month period, 4% of 125 PD patients (n=5) self-reported UEF without prompting. Of these, 2 patients had UEF (1.2% of 125) in isolation and 3patients (2.8% of 125) reported UEF in addition to freezing in other body areas. No additional patients were identified with OT indirect questioning via a functional ADL questionnaire. After a one month period (n=45) of direct questioning about UEF, 9% of 45 PD patients reported UEF. Conclusions: Motor blocks are a major disabling feature in advanced PD. This preliminary data suggests that UEF may be an under-recognized entity. Further prospective studies should be pursued to assess prevalence of UEF as interventions targeting this symptom may improve independence and quality of life in PD patients.