Gait Analysis of Old Individuals with Mild Parkinsonian Signs and Those Individuals’ Gait Performance Benefits Little from Levodopa

Abstract

Background and Purpose: Gait analysis and the effects of levodopa on the gait characteristics in Mild parkinsonian signs (MPS) are rarely published. The present research aimed to (1) analyze the gait characteristics in MPS; (2) explore the effects of levodopa on the gait performance of MPS. Methods: We enrolled 22 inpatients with MPS and 20 healthy control subjects (HC) from Nanjing Brain Hospital. The Unified Parkinson's Disease Rating Scale was used to evaluate motor symptoms. Acute levodopa challenge test was performed to explore the effects of levodopa on the gait performance of MPS. The instrumented stand and walk test was conducted for each participant and the JiBuEn gait analysis system was used to collect gait data. Results: For spatiotemporal parameters: Compared with HC, the state before taking levodopa/benserazide in MPS group (meds-off) demonstrated a decrease in stride length (SL) (p≤0.001), an increase in SL variability (p≤0.001), and swing phase time variability (p=0.016). Compared with meds-off, the state after 1 hour of taking levodopa/benserazide in MPS group (meds-on) exhibited an increase in SL (p≤0.001), a decrease in SL variability (p≤0.001). For kinematic parameters: Compared with HC, meds-off demonstrated a decrease in heel strike angle (p=0.008), range of motion (ROM) of knee joint (p=0.011) and ROM of hip joint (p=0.007). Compared with meds-off, meds-on exhibited an increase in HS (p≤0.001). Bradykinesia and rigidity scores were significantly correlated with gait parameters. Conclusion: Although the clinical symptoms of the MPS group are mild, their gait damage is obvious and they exhibited a decreased SL and joints movement, and a more variable gait pattern. Levodopa had little effect on the gait performance of those individuals.

Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

“…15 Previous studies have noted that rigidity and postural instability may reduce forward propulsion and thereby negatively affect stride length and stride velocity. 23,[50][51][52][53] As such, sustained improvements to rigidity and postural instability due to sensory exercise may then translate to improvements in gait parameters. 54,55 In comparison, stride length and stride velocity did not change at washout for the boxing group.…”

Translating digital healthcare to enhance clinical management: a protocol for an observational study using a digital health technology system to monitor medication adherence and its effect on mobility in people with Parkinson’s

“…At present, research exploring medication and mobility in PwP is typically conducted in controlled lab-based or clinical environments, in specific ON/OFF medication states. [8][9][10][11][12][13][14][15][16] Although some studies have been performed in the real world (ie, daily living, outside clinical or laboratory settings), 17 18 a more granular picture is required.…”

A Systematic Review of Non-Pharmacological Interventions to Improve Gait Asymmetries in Neurological Populations

“…These findings are not isolated to levodopa, as there are other pharmacological approaches to addressing gait challengesparticularly in individuals with PD [14]. However, gait symmetry is typically not a primary outcome variable in these studies and no pharmacological interventions are known to enhance gait symmetry [15][16][17].…”