Staircase climbing is not solely a visual compensation strategy to alleviate freezing of gait in Parkinson’s disease

In a recent case study by Janssen et al. [1], the authors reported that Freezing of Gait (FOG) was alleviated in an individual with Parkinson’s disease (PD) when climbing stairs, an effect that was preserved when walking on a painted 3D staircase illusion. This is an important observation, as the clinical management of FOG remains challenging [2] due in part to a lack of consensus regarding the underlying mechanisms driving effective compensation [1, 3, 4]. The authors provided three hypotheses as to why 3D visual cues helped to alleviate FOG: enhanced visual feedback from 3D cues were thought to either: (1) force individuals to lift their feet higher; (2) perform larger lateral weight shifts; and/or (3) compensate for visuomotor deficits [1]. Here, we refine these hypotheses by providing evidence that the compensatory mechanisms involved during staircase climbing in PD patients with FOG are not solely visual [1, 3, 4].