Abstract
BackgroundGait performance is widely evaluated to assess health status in older adult populations. While several investigators have presented normative values for spatiotemporal gait parameters drawn from older adult populations, the literature has been void of large-scale cohort studies, which are needed in order to provide quantitative, normative gait data in persons with Parkinson’s disease. The aim of this investigation was to provide reference values for clinically important gait characteristics in a large sample of ambulatory persons with Parkinson’s disease to aid both clinicians and researchers in their evaluations and treatments of gait impairment.Methodology/Principal FindingsGait performance was collected in 310 individuals with idiopathic Parkinson’s disease as they walked across a pressure sensitive walkway. Fourteen quantitative gait parameters were measured and evaluated with respect to Hoehn and Yahr disease staging and gender. Disease duration and age were controlled for in all analyses. Individuals with the greatest Parkinson’s disability walked significantly slower with shorter steps and stride lengths than the mild and moderately affected groups. Further, the most affected patients spent more time with both feet on the ground, and walked with a wider base of support than the moderately disabled patients. No differences were detected between the mild and moderate disability groups on any of the gait parameters evaluated.Conclusions/SignificanceReference values for 14 gait parameters in a large cohort of ambulatory patients with Parkinson’s disease are provided and these may be highly useful for assessing and interpreting an individual’s gait dysfunction. It is important for clinicians and researchers to appreciate the lack of change in quantitative parameters as PD patients move from mild to moderate gait impairment.
Highlights
Gait impairment in Parkinson’s disease (PD) is often compounded by the presence of the other cardinal features of bradykinesia, rigidity, and postural instability
It is not surprising that gait impairment in PD is closely related to poor quality of life and to increased patient distress
These variables provide further insight into the nature of the walking behavior beyond just the simple speed of movement. Each of these gait features has been related to other health domains relevant to the older adult including brain atrophy, executive function, memory decline, subtypes of mild cognitive impairment, and fall risk [7,8,9,10,11,12]. These findings suggest that these spatiotemporal variables are relevant to defining gait performance, but may be important indices relating to overall health
Summary
Gait impairment in Parkinson’s disease (PD) is often compounded by the presence of the other cardinal features of bradykinesia, rigidity, and postural instability. Other important spatiotemporal features of gait that are often evaluated clinically include step and stride length, and step width These variables provide further insight into the nature of the walking behavior beyond just the simple speed of movement. Each of these gait features has been related to other health domains relevant to the older adult including brain atrophy, executive function, memory decline, subtypes of mild cognitive impairment, and fall risk [7,8,9,10,11,12]. The primary aim of this investigation was to provide reference values for clinically important gait characteristics in a large sample of ambulatory persons with PD at various stages of the disease
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