Techniques for the detection and management of freezing of gait in Parkinson's disease – A systematic review and future perspectives

Freezing of Gait (FoG) is one of the most critical debilitating motor symptoms of advanced Parkinson's disease (PD) with a higher rate of occurrence in aged people. PD affects the cardinal motor functioning and leads to non-motor symptoms, including cognitive and neurobehavioral abnormalities, autonomic dysfunctions and sleep disorders. Since its pathogenesis is complex and unclear yet, this paper targets the studies done on the pathophysiology and epidemiology of FoG in PD. Gait disorder and cardinal features vary from festination (involuntary hurrying in walking) to freezing of gait (breakdown of repetitive movement of steps despite the intention to walk) in patients. Hence, it is difficult to assess the FoG in clinical trials. Therefore, the current research emphasizes wearable sensor-based systems over pharmacology and surgical methods. • This paper presents a technological review of various techniques used for the assessment of FoG with a comprehensive comparison. • Researchers are aiming at the development of wireless sensor-based assistive devices to (a) predict the FoG episode in a different environment, (b) acquire the long-term data for real-time analysis, and (c) cue the FoG patients. • We summarize the work done till now and future research directions needed for a suitable cueing mechanism to overcome FoG.