Step Length Is a Promising Progression Marker in Parkinson’s Disease

Abstract

Current research on Parkinson’s disease (PD) is increasingly concerned with the identification of objective and specific markers to make reliable statements about the effect of therapy and disease progression. Parameters from inertial measurement units (IMUs) are objective and accurate, and thus an interesting option to be included in the regular assessment of these patients. In this study, 68 patients with PD (PwP) in Hoehn and Yahr (H&Y) stages 1–4 were assessed with two gait tasks—20 m straight walk and circular walk—using IMUs. In an ANCOVA model, we found a significant and large effect of the H&Y scores on step length in both tasks, and only a minor effect on step time. This study provides evidence that from the two potentially most important gait parameters currently accessible with wearable technology under supervised assessment strategies, step length changes substantially over the course of PD, while step time shows surprisingly little change in the progression of PD. These results show the importance of carefully evaluating quantitative gait parameters to make assumptions about disease progression, and the potential of the granular evaluation of symptoms such as gait deficits when monitoring chronic progressive diseases such as PD.

Does Executive Function Influence Walking in Acutely Hospitalized Patients With Advanced Parkinson's Disease: A Quantitative Analysis

“…Rather, the severity of PD-specific motor symptoms seems true to inflict the walking performance in this and other PD cohorts. Specifically, under ST, the increase in motor symptoms explains a decrease in spatio-temporal walking parameters, e.g., gait speed, which is also consistent with previous studies ( 14 , 75 ). Moreover, our results suggest that patients with a walking aid are more affected by the underlying disease.…”

Parkinson’s disease multimodal complex treatment improves gait performance: an exploratory wearable digital device-supported study

“…As expected, the mean values of gait velocity in this study were smaller than in healthy males [68] and correspond to normative data in early-stage PD during convenient walking [69]. We were thus able to confirm earlier findings from cross-sectional studies that showed a negative association between gait speed and (motor) disease stage in PD [69][70][71][72][73]. Analogously, larger sway areas at more severe disease stages have been described previously [74,75].…”

“…This association may be of precedential interest for future clinical decisionmaking (see below). It has already been shown that PD per se [76], advanced disease stage [69,70], PIGD phenotype [77], medication OFF states [78][79][80], and dual-tasking with cognitive load [81][82][83][84] are associated with shortened step and stride lengths. Dual-tasking abilities are particularly relevant to daily life and may predict daily functioning in PD [85].…”

Gait Analysis with Wearables Is a Potential Progression Marker in Parkinson’s Disease

“…From this indicator, balance and cognitive function are impaired in the early stage of PD. Another study also found changes in SL as PD progressed, but they did not find changes in SL in the early stages of PD, which may be related to their relatively small sample sizes [ 29 ]. GV also deteriorates significantly as PD progresses, which also reflects the characteristics of bradykinesia in PD patients.…”