No relevant association of kinematic gait parameters with Health-related Quality of Life in Parkinson’s disease

Abstract

BackgroundHealth-related Quality of Life (HrQoL) is probably the most important outcome parameter for the evaluation and management of chronic diseases. As this parameter is subjective and prone to bias, there is an urgent need to identify objective surrogate markers. Gait velocity has been shown to be associated with HrQoL in numerous chronic diseases, such as Parkinson’s disease (PD). With the development and wide availability of simple-to-use wearable sensors and sophisticated gait algorithms, kinematic gait parameters may soon be implemented in clinical routine management. However, the association of such kinematic gait parameters with HrQoL in PD has not been assessed to date.MethodsKinematic gait parameters from a 20-meter walk from 43 PD patients were extracted using a validated wearable sensor system. They were compared with the Visual Analogue Scale of the Euro-Qol-5D (EQ-5D VAS) by performing a multiple regression analysis, with the International Classification of Functioning, Disability and Health (ICF) model as a framework.ResultsUse of assistive gait equipment, but no kinematic gait parameter, was significantly associated with HrQoL.ConclusionThe widely accepted concept of a positive association between gait velocity and HrQoL may, at least in PD, be driven by relatively independent parameters, such as assistive gait equipment.

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“…While this argument is comprehensible, the EQ-5D indubitably has been commonly used for the assessment of QoL in many different patient populations, including PD patients [34][35][36] and it is reasonable that this instrument will also be used frequently in future studies, not least because of its simplicity and brevity [37]. Due to this, a direct comparison of the EQ-5D…”

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“…The reason relates to a mismatch between a patient’s functional needs, preferences and environmental constrains, and health professionals’ perspectives. In 2017, Bettecken et al [ 48 ] reported a relationship between PD patients’ gait velocity using an assistive mobile device and their HrQoL. Surprisingly, the study did not show a relevant contribution of gait velocity to HrQoL.…”

“…More studies are needed to understand the relationship between the use of assistive mobility devices, PD patients’ functional mobility and HrQoL. Perceived control may be the key aspect in explaining the intriguing conclusion that Bettecken and colleagues found in their study [ 48 ]. As mentioned above, perceived control is a powerful predictor of functioning and it seems that some patients place more value on the capability of performing ADL rather than the time it takes to perform specific tasks [ 26, 49 ].…”

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“…As motor impairments progress, the risk of falls increases and patients become more dependent (for example, being in need of using walking aids). Both factors are associated with reduced quality of life (4,7). To detect motor impairment in PD, wearable devices have been increasingly used in recent years as a flexible and cost-effective option in clinical settings (7)(8)(9)(10).…”

“…Both factors are associated with reduced quality of life (4,7). To detect motor impairment in PD, wearable devices have been increasingly used in recent years as a flexible and cost-effective option in clinical settings (7)(8)(9)(10).…”