Gait Characteristics under Imposed Challenge Speed Conditions in Patients with Parkinson’s Disease During Overground Walking

Abstract

Evaluating gait stability at slower or faster speeds and self-preferred speeds based on continuous steps may assist in determining the severity of motor symptoms in Parkinson’s disease (PD) patients. This study aimed to investigate the gait ability at imposed speed conditions in PD patients during overground walking. Overall, 74 PD patients and 52 age-matched healthy controls were recruited. Levodopa was administered to patients in the PD group, and all participants completed imposed slower, preferred, and faster speed walking tests along a straight 15-m walkway wearing shoe-type inertial measurement units. Reliability of the slower and faster conditions between the estimated and measured speeds indicated excellent agreement for PD patients and controls. PD patients demonstrated higher gait asymmetry (GA) and coefficient of variance (CV) for stride length and stance phase than the controls at slower speeds and higher CVs for phases for single support, double support, and stance. CV of the double support phase could distinguish between PD patients and controls at faster speeds. The GA and CVs of stride length and phase-related variables were associated with motor symptoms in PD patients. Speed conditions should be considered during gait analysis. Gait variability could evaluate the severity of motor symptoms in PD patients.

Association between Gait Variability and Gait-Ability Decline in Elderly Women with Subthreshold Insomnia Stage

“…Although healthy elderly participants performed the gait tasks successfully, they indicated greater GV than young adults, owing to physiological changes caused by increased neuromotor noise [ 5 ]. A similar study reported that Parkinson’s patients exhibited 2.1 times (110%) greater CV for the double support phase, compared with their age-matched elderly controls at a faster speed; it was suggested that this result might be related to the control of automatized behavior [ 28 ].…”

“…Before the treadmill test, all the participants completed overground walking tests in a straight 10-m walkway, to calculate their self-preferred walking speed (distance/walking duration) ( Figure 2 ). Slower (80% of preferred speed) and faster (120% of preferred speed) speeds were calculated relative to the preferred speed [ 27 , 28 ]. For instance, if the measured preferred speed was 1.0 m/s, then slower and faster speeds are 0.8 m/s and 1.2 m/s, respectively.…”

“…Moreover, most previous studies used averaged data through repeated trials to collect multiple steps (not continuous steps); however, with this method, it may be difficult to replicate the natural walking patterns of individuals [ 25 ]. Recently, a significant decline in gait ability has been reported, based on the quantitative speed value range (e.g., ±20% of the individual’s preferred walking speed); this speed value range has been validated in healthy young adults [ 26 ], elderly adults [ 27 ], and Parkinson’s patients [ 28 ]. Thus, gait stability at slower, faster speeds, and self-preferred speeds may be beneficial to understanding the gait characteristics in elderly women with subthreshold insomnia.…”

Low composite functional movement screen score associated with decline of gait stability in young adults

“…Recently, an inertial measurement unit (IMU) system for gait analysis has exhibited validity and reliability in healthy individuals ( Joo, Kim & Park, 2015 ; Kanzler et al, 2015 ; Mariani et al, 2010 ) and patients ( Trojaniello et al, 2014 ; Trojaniello et al, 2015 ; Lee et al, 2018 ); thus, numerous researchers have suggested this alternative approach for gait analysis ( Joo, Kim & Park, 2015 ; Kanzler et al, 2015 ; Mariani et al, 2010 ; Trojaniello et al, 2014 ; Lee et al, 2018 ; Cole et al, 2014 ). Several studies that used the IMU system have reported a significant decline in gait ability based on quantitative speed conditions (e.g., ±20% of the preferred walking speed of an individual), and gait tasks at these speed conditions have been validated in healthy young adults ( Han et al, 2019 ), older adults ( Noh et al, 2020 ; Lee et al, 2020a ), and patients with Parkinson’s disease ( Lee et al, 2020b ). Thus, gait tasks at slower, faster, and self-preferred speeds using the IMU system may demonstrate specific characteristics in young adults, based on a TFMS cut-off score of 14 out of 21.The purpose of this study was to investigate the association between gait ability and fundamental movement patterns in young adults using a TFMS with a cut-off score of 14.…”

Mechanical Plantar Foot Stimulation in Parkinson′s Disease: A Scoping Review

“…There is substantial evidence that the spatial characteristics of simple, straight-ahead gait is improved with levodopa and levodopa-enhancing drugs [17,18], but it is unclear whether more complex walking skills, such as gait initiation and gait adjustments, improve with dopaminergic treatment. The effects of dopaminergic treatment on stability measures of gait, such as spatial and temporal variability, are as yet inconclusive [17,19]. Some studies show that drug treatment can negatively affect aspects of gait and balance in individuals with Parkinson s disease [17,20].…”