supplementary motor area - SMA) that comprise a known brain circuitry dedicated to APA control ( de Lima-Pardini et al., 2017 Jacobs et al., 2009a Bolzoni et al., 2015). Physiological evidence, functional imaging and clinical-pathological studies suggest that FoG is mainly associated with disorders of frontal cortical regions (e.g. In PD, FoG episodes are associated with deficient APA ( Mancini et al., 2016 Schlenstedt et al., 2018). This often results in knee trembling and failure to initiate gait. During imminent FoG episodes, the intention to walk is uncoupled from the triggering of APA, with consequent failure of the forward movement. Normal gait requires an exact coordination of postural adjustment in advance of each step forward, namely anticipatory postural adjustment (APA) ( de Lima-Pardini et al., 2017). While taking a step forward in unsupported biped position, the body weight is shifted toward the supporting leg. Freezing of gait (FoG) is described as brief and episodic absence or marked reduction of the anterior progression of the feet, despite the intention to walk ( Giladi and Nieuwboer, 2008). PIGD is the most common cause of falls, which are associated with increase in morbimortality in PD ( Bloem et al., 2004 Delval et al., 2014). Postural instability and gait disorders (PIGD) are debilitating phenomena that frequently impair locomotion and can significantly affect the quality of life in Parkinson’s disease (PD) patients ( Perez-Lloret et al., 2014). On the other hand, reactive posture control to external perturbation that mainly relies on neuronal circuitries involving the brainstem and spinal cord, is less influenced by SCS. SCS seems to influence cortical motor circuits, involving the supplementary motor area. However, SCS failed to improve reactive postural responses. In general, the results showed that SCS improved FoG and APA. Anticipatory postural adjustment (APA), reactive postural responses, gait and FoG were biomechanically assessed. Four patients with FoG were implanted with SCS systems in the upper thoracic spine. ![]() The aim of this study is to assess the effects of SCS on FoG and distinct domains of postural control. Spinal cord stimulation (SCS) is a promising intervention for FoG in patients with PD, however, its effects on distinct domains of postural control is not well known. ![]() Freezing of gait (FoG) in Parkinson’s disease (PD) is an incapacitating transient phenomenon, followed by continuous postural disorders.
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