Dataset Information

Speeding Up Gait in Parkinson's Disease.

ABSTRACT: BACKGROUND:Gait speed is an important outcome that relates to mobility, function, and mortality, and is altered in people with Parkinson's disease (PwPD). However, changes in gait speed may not reflect changes in other important aspects of gait. OBJECTIVE:To characterize which outcomes change concomitantly with walking speed in PwPD. This information can inform the choice of outcome variables for characterizing and tracking gait performance in this population. METHODS:67 PwPD and 40 neurotypical adults completed 2-minute overground walking bouts at comfortable and fast self-selected speeds. Eight inertial sensors were used to characterize gait and turning. We identified a subset of participants (38 per group) where the PD participant's "fast" walk was similar speed to neurotypical participants "comfortable" walk, facilitating an across-group gait comparison controlling for gait speed. RESULTS:Walking at fast gait speed compared to comfortable lead to significant changes in stride length, cadence, and stride time variability, but not in steps to turn, trunk ROM, and trunk and lumbar stability in PwPD. Sub-group analyses showed that despite walking at a similar speed as neurotypical adults, PwPD exhibit altered turning outcomes, lumbar stability, and stride length/cadence. CONCLUSIONS:Gait speed is a critical outcome for characterizing mobility. However, in PwPD, several important outcomes do not exhibit a uniform relationship with gait speed, and remain altered compared to neurotypical adults despite "normalizing" walking speed. Given the complex relationship between gait speed and other gait quality measures, care should be taken when choosing outcome measures to characterize the breadth of gait abnormality in PwPD.

SUBMITTER: Peterson DS

PROVIDER: S-EPMC7304052 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Speeding Up Gait in Parkinson's Disease.

Peterson Daniel S DS Mancini Martina M Fino Peter C PC Horak Fay F Smulders Katrijn K

Journal of Parkinson's disease 20200101 1

<h4>Background</h4>Gait speed is an important outcome that relates to mobility, function, and mortality, and is altered in people with Parkinson's disease (PwPD). However, changes in gait speed may not reflect changes in other important aspects of gait.<h4>Objective</h4>To characterize which outcomes change concomitantly with walking speed in PwPD. This information can inform the choice of outcome variables for characterizing and tracking gait performance in this population.<h4>Methods</h4>67 Pw ...[more]

PMID: 31561384

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Project description:Distinct gait characteristics like short steps and shuffling gait are prototypical signs commonly observed in Parkinson's disease. Routinely assessed by observation through clinicians, gait is rated as part of categorical clinical scores. There is an increasing need to provide quantitative measurements of gait, e.g. to provide detailed information about disease progression. Recently, we developed a wearable sensor-based gait analysis system as diagnostic tool that objectively assesses gait parameter in Parkinson's disease without the need of having a specialized gait laboratory. This system consists of inertial sensor units attached laterally to both shoes. The computed target of measures are spatiotemporal gait parameters including stride length and time, stance phase time, heel-strike and toe-off angle, toe clearance, and inter-stride variation from gait sequences. To translate this prototype into medical care, we conducted a cross-sectional study including 190 Parkinson's disease patients and 101 age-matched controls and measured gait characteristics during a 4x10 meter walk at the subjects' preferred speed. To determine intraindividual changes in gait, we monitored the gait characteristics of 63 patients longitudinally. Cross-sectional analysis revealed distinct spatiotemporal gait parameter differences reflecting typical Parkinson's disease gait characteristics including short steps, shuffling gait, and postural instability specific for different disease stages and levels of motor impairment. The longitudinal analysis revealed that gait parameters were sensitive to changes by mirroring the progressive nature of Parkinson's disease and corresponded to physician ratings. Taken together, we successfully show that wearable sensor-based gait analysis reaches clinical applicability providing a high biomechanical resolution for gait impairment in Parkinson's disease. These data demonstrate the feasibility and applicability of objective wearable sensor-based gait measurement in Parkinson's disease reaching high technological readiness levels for both, large scale clinical studies and individual patient care.

Dataset Information

Speeding Up Gait in Parkinson's Disease.

Publications

Speeding Up Gait in Parkinson's Disease.

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