Quantitative analysis of gait in Parkinson patients: increased variability of stride length

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

“…These results are consistent with earlier findings that reported increased stride-to-stride variability among patients with PD (Blin et al, 1990;Blin et al, 1991;Hausdorff et al, 1998), but extend these results in a number of ways. These findings demonstrate that the locomotor control system's ability to regulate the stride-to-stride variations in gait timing is especially impaired among PD participants with a history of falls.…”

“…Participants were tested under the following conditions: 1) Baseline: (usual walking for 100 meters); 2) RAS set to each participant's normal cadence; 3) Usual walking (to assess any carryover effect); 4) RAS set to 110% of usual cadence; 5) Usual walking (to assess immediate carryover effect); and 6) Usual walking 15 min later (to assess longer carryover). As in previous studies (Blin et al, 1990;Hausdorff et al, 1998;Hausdorff et al, 2000;Schaafsma et al, 2003), both stride time variability and swing time variability were significantly increased in the participants with PD compared to the controls under usual walking conditions (p < .01). When RAS was set to each participant's usual cadence, the variability of the stride time and swing time tended to decrease among the participants with PD, but the effect was not significant.…”

“…Patients with PD walk with increased stride-to-stride variability and have a decreased fractal scaling index (Blin, Ferrandez, & Serratrice, 1990;Frenkel-Toledo et al, 2005b;Hausdorff et al, 1998;Hausdorff, Peng et al, 1995;Hausdorff et al, 2000). Increased stride-to-stride variability, both in the stride length and stride time, has been observed in advanced PD (Blin et al, 1990;Hausdorff et al, 1998;Stolze et al, 2001) as well as in patients early in the disease process who have not even begun to take anti-parkinsonian medications (Baltadjieva, Giladi, Gruendlinger, Peretz, & Hausdorff, 2006;Hausdorff, Peng et al, 1995). In fact, in these patients with de novo PD, it has been shown that the increased stride-to-stride variability apparently is independent of a reduced stride length and apparently does not reflect inconsistent motor unit recruitment or muscle force output.…”

“…Gait variability may help to enhance the early identification of potential fallers in PD, as it does in other populations. A few studies have observed increased variability in patients with PD compared to controls, noting that this variability tends to increase with disease severity (Blin et al, 1990;Blin, Ferrandez, Pailhous, & Serratrice, 1991;Hausdorff et al, 1998). In general, however, the relationships between gait variability, fall risk, and other parkinsonian features were not wellstudied and the effect of levodopa on falls and gait variability were also largely unknown.…”

Loss of gait control assessed by cognitive-motor dual-tasks: pros and cons in detecting people at risk of developing Alzheimer’s and Parkinson’s diseases

“…PD patients typically increased their cadence to compensate for reduced stride length (Morris et al 1994). Concerning the other pace parameters, some studies showed that increases in stride time variability and swing time variability are likely due to the inability to generate Binternal cues^in the supplementary motor areas, a necessary step in the creation of a normal sequenced movement (Yogev et al 2005) According to Blin et al (1990), deficits in muscle strength, of which the exact neuropathological Yogev et al (2005) suggest that deficits in executive attention control may also contribute to these changes among PD patients. Decreased arm swing amplitude of the more affected body side is frequently reported in the literature.…”