Single- and dual-task gait parameters in determination of cerebral small vessel disease

Abstract

Background and objective: Gait disorder is one of the primary symptoms of cerebral small vessel disease (CSVD) and its potential diagnostic value was not known. We aimed to investigate the gait performance in CSVD and to determine the diagnostic value of gait parameters for CSVD under single-task and dual-task walking conditions. Methods: We prospectively recruited consecutive patients with CSVD from January 1, 2022 to August 31, 2023. A total of 129 CSVD patients and 71 healthy controls were enrolled. Direct gait parameters in the patient group and the control group were compared under single-task and dual-task conditions, controlling for covariates. Gait parameters were compared between the two groups, using the receiver operating characteristic curve. Results: Compared to controls, participants with CSVD had shorter stride length, slower stride speed, shorter cadence, longer stance time/phase, longer stride time, shorter swing phase, smaller average toe-off angle and smaller heel stride angle either in single-task walking test or in dual-task walking test (all P<0.05). Average heel strike angle could distinguish CSVD from healthy controls both in single-task (AUC = 0.858, P < 0.001, sensitivity, 83.1%; specificity, 76.7%) and dual-task walking tests (AUC = 0.865, P < 0.001, sensitivity, 91.5%; specificity, 70.5%) with moderate accuracy, independent of covariates. Conclusion: Gait patterns changed in patients with CSVD. Our findings suggest that average heel strike angle was one of the most valuable gait parameters of altered gait in CSVD and that could serve as a diagnostic marker of CSVD.