Patient‐reported and performance‐based measures of walking in mild–moderate Parkinson's disease

Abstract

BackgroundKnowledge of the relationships between patient‐reported and performance‐based walking measures in Parkinson's disease (PD) should inform clinical decision‐making. The Walk‐12G reliably captures perceived walking difficulties but has not been compared to performance‐based walking in laboratory or free‐living settings or across different groups.ObjectivesTo investigate the relationship between patient‐reported walking difficulties (Walk‐12G) and performance‐based walking in laboratory and free‐living conditions and to determine whether the Walk‐12G can distinguish between the subgroups, (i) people with/without PD and (ii) mild/moderate disease stages.MethodsForty‐seven people without and 49 people with PD (Hoehn and Yahr stage II and III) were assessed in relation to patient‐reported walking difficulties (Walk‐12G scale); spatiotemporal gait characteristics (Pace; Rhythm; Asymmetry; Variability; and Postural control) using a laboratory‐based electronic walkway; and walking behavior (mean steps/day and minutes of brisk walking/day) using accelerometers in free‐living conditions.ResultsThe Walk‐12G correlated moderately with the spatiotemporal domain step velocity (r = −0.46) and walking behavior, measured as mean steps/day (r = −0.46). Weaker correlations were observed for step length and minutes spent in brisk walking (r = −0.36 and r = −0.35, respectively). Poor correlations were observed for all other spatiotemporal domains. The Walk‐12G could distinguish between people with and without PD (Effect size, r = 0.82) and between those at mild/moderate disease stages (r = 0.34).ConclusionsPerceived walking difficulties showed weak to moderate associations with performance‐based measures of walking in mild–moderate PD. As the strongest associations were observed for step velocity and walking behavior, targeting these specific gait aspects could improve perceived walking difficulties in daily life.

Perceived walking difficulties in Parkinson’s disease – predictors and changes over time

“…The independent variables in the present study were selected based on theoretical reasoning as well as on the results from previous cross-sectional studies 16,17 . The regression models in our study explained 61.7% and 67.6% of the variance in the Walk-12G scores, respectively.…”

“…One study found that two objective gait domains (i.e. pace and variability) were moderately associated with perceived walking di culties 16 . Another cross-sectional study, based on the same sample as the present study, identi ed FOG as the strongest contributing factor, followed by general self-e cacy, fatigue, PD duration, lower extremity function, orthostatic hypotension, bradykinesia and postural instability 17 .…”

The Use of Inertial Measurement Units for the Study of Free Living Environment Activity Assessment: A Literature Review

“…Some of those clinical studies aim at quantifying patient’s pathology [ 6 , 7 , 27 , 69 , 70 ], while others quantify the therapeutic effect on the patient’s condition [ 5 , 68 ]. Some clinical trials focus on healthy participants, some compare the patients included with healthy participants [ 39 , 42 , 71 , 72 ], while others dwell specifically upon cohorts with a medical condition. Perriot et al [ 7 ] intended to improve posture detection in COPD participants and Nguyen et al [ 63 ] focused on activity classification in patients with PD.…”

“…Finally, papers comparing the conditions and results in free-living conditions with those obtained in controlled environments [ 40 , 72 , 74 , 77 , 78 ] and papers dealing with the detection of ancillary parameters (such as wear-time [ 79 , 80 ], walking bouts [ 72 , 75 , 81 ], strides or steps [ 40 , 71 , 81 ], etc.) constitute the fifth and sixth distinct groups of respectively 10 studies and five studies.…”

“…One type of instruction regularly found in semi-FLEs [ 5 , 16 , 60 , 71 , 76 , 78 , 82 , 85 , 89 , 104 , 105 ] is the presentation of the activities to be performed: how to perform them and for how long. These instructions are classified as “Imposed activities with specific instructions”.…”