Gait velocity and step length at baseline predict outcome of Nordic walking training in patients with Parkinson's disease.

Abstract

The impact of Nordic walking (NW) in Parkinson's disease (PD) has been investigated in several studies but results are inconsistent. This may be due to different cohorts studied and the heterogeneity of their PD symptoms which impact the outcome of NW. This study aimed at determining predictive factors for a positive effect of NW on PD. Primary outcome was to define the baseline disease-associated and demographic parameters that distinguish patients who demonstrate improvement in the Unified PD rating scale (UPDRS) motor part following NW training ("U+") from those patients with no improvement after the same intervention ("U-"). The potentially predictive parameters were: age, age at onset, disease duration, gait velocity, step length, daily step number, UPDRS-motor part, Berg-Balance-Scale, Parkinson-Neuropsychometric-Dementia-Assessment, verbal-fluency-test and Becks-Depression-Inventory-II. Twenty-two PD patients (H&Y stage 2-2.5) performed twelve weeks of NW training. Eighteen patients were included in the final analysis. Overall, the UPDRS motor part did not improve significantly; however, eight patients had an improvement in the UPDRS motor part from baseline to end of study (U+). When comparing the potentially predictive factors of the U+ cohort with those ten patients who did not improve (U-), there was a notable difference in gait velocity and step length, and showed a significant correlation with an improvement in the UDPRS motor part scores. Gait velocity and step length can predict the outcome of NW training as determined by the UPDRS motor part, indicating that PD patients with only slightly impaired gait performance benefit most.