Introduction: Parkinson’s disease (PD) is a neurodegenerative disease characterized by motor symptoms and gait impairments. Among them, freezing of gait (FOG) is one of the most disabling manifestations. Backward walking (BW) is an activity of daily life that individuals with PD might find difficult and could cause falls. Recent studies have reported that gait impairments in PD were more pronounced in BW, particularly in people presenting FOG. However, to the best of our knowledge, no systematic review has synthetized the literature which compared BW performance in PD patients with and without FOG. Objective: The aim of this study was to evaluate the differences in BW performance between PD patients with FOG and PD patients without FOG. Methods: Two databases, PubMed and Web of Science, were systematically searched to identify studies comparing BW performance in PD patients with and without FOG. The National Institutes of Health (NIH) tool was used to assess the quality of the studies included. Results: Seven studies with 431 PD patients (179 PD with FOG and 252 PD without FOG) met the inclusion criteria and were included in this review. Among them, 5 studies reported walking speed, 3 studies step length, stride length and lower limb range of motion, 2 studies functional ambulation profile, toe clearance height, swing, and stance percent and 1 study reported the decomposition index and stepping coordination. Compared to PD patients without FOG, PD patients with FOG showed slower walking speed and reduced step length in 3 studies, shorter stride length, lower functional ambulation profile and decreased ankle range of motion in 2 studies, and smaller swing percent, higher stance percent, worse stepping coordination, greater decomposition between movements, and lower toe clearance height in one study. Conclusion: Despite the small number of included studies, the findings of this review suggested that PD patients with FOG have worse gait performance during the BW task than PD without FOG.
This study aimed to systematically review and summarize the available data regarding the influence of overweight and obesity across the lifespan on obstacle crossing during walking. Four databases were systematically searched with no limitation on publication date following the Cochrane Handbook for Systematic Reviews and PRISMA guidelines. Only full-text English-language articles published in a peer-reviewed journal were eligible. They had to compare obstacle crossing during walking by overweight or obese individuals with individuals of normal body weight. Five studies were considered eligible. All the studies assessed kinematics; only one assessed kinetics, but none investigated muscle activity or obstacle contact. Compared to normal individuals crossing obstacles, overweight or obese individuals exhibited lower velocity, shorter step length, lower cadence, and less time spent in single-limb support. They also exhibited increased step width, more time spent in double support, and greater trailing leg ground force reaction and centre of mass acceleration. Overall, the small number of included studies did not allow us to draw any conclusions. However, being overweight or obese seems to have a potentially negative influence on the kinematics of gait parameters due to a tendency to trip, fall, and suffer severe fall-related injuries when negotiating obstacles on foot in real-life environments.
Background Overweight and obesity are significant global health concerns that involve deficits in gait and balance that affect daily activities. Although much is reported about the effect of overweight and obesity on gait during unobstructed walking, not much is known about how overweight and obesity could impact gait under more challenging conditions, such as environments with obstacles. Objective The aim of this study is to systematically review and synthesize the available data regarding the effects of overweight and obesity on obstacle crossing during walking. Methods This review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. PubMed, Web of Science, Scopus, and SPORTDiscus will be systematically searched with no limitations on publication date. Only full-text English-language articles published in a peer-reviewed journal will be included. Included articles must have compared obstacle crossing during walking in individuals with overweight or obesity to individuals of normal body weight. A total of 2 independent reviewers will select the articles and extract the following 4 sets of data: (1) study characteristics, (2) sample description, (3) obstacle crossing task protocol, and (4) main results obtained. If a considerable number of homogeneous papers are included, a meta-analysis will be conducted. A preliminary search was conducted in November 2021. Results The results will include the article selection flowchart as well as tables and figures synthesizing the extracted data on the effects of overweight and obesity on obstacle crossing during walking. The preliminary search identified 73 original records, of which 5 articles met the inclusion criteria. Conclusions This review will present researchers and clinicians with an overview of published studies that have compared the performance of obstacle crossing for individuals with overweight and obesity to those of normal body weight. Gaining insight into the control strategies adopted by individuals with overweight and obesity is critical for safe and successful obstacle crossing in this population. We therefore believe that our findings could be useful for identifying people at risk of falls and developing and implementing fall prevention programs for individuals with overweight and obesity. Trial Registration PROSPERO CRD42021269949; https://tinyurl.com/3yrwccu4 International Registered Report Identifier (IRRID) DERR1-10.2196/36234
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