Walking economy in people with Parkinson's disease

Christiansen, Cory L.; Schenkman, Margaret; McFann, Kim; Wolfe, Pamela; Kohrt, Wendy M.

doi:10.1002/mds.22621

Cited by 87 publications

(81 citation statements)

References 45 publications

(75 reference statements)

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“…Previous PD-studies have shown that fatigue is associated with walking economy [52], and with lower levels of self-reported [53,54] as well as objectively measured [55] physical activity. Moreover, lower limb muscle fatigue (i.e., physical fatigue) is associated with objectively measured gait parameters in people with PD [9].…”

Section: Discussionmentioning

confidence: 91%

Factors Contributing to Perceived Walking Difficulties in People with Parkinson’s Disease

Kader

Ullén

Iwarsson

et al. 2017

JPD

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Section: Discussionmentioning

confidence: 91%

Factors Contributing to Perceived Walking Difficulties in People with Parkinson’s Disease

Kader

Ullén

Iwarsson

et al. 2017

JPD

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“…Impaired walking economy may cause fatigue in people with PD [48], which might potentially explain the association between fatigue and FOF since walking and FOF are closely related.…”

Section: Discussionmentioning

confidence: 99%

Concerns About Falling in Parkinson’s Disease: Associations with Disabilities and Personal and Environmental Factors

Jonasson

Ullén

Iwarsson

et al. 2015

JPD

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Abstract.Background: Fear of falling can be conceptualized in different ways, e.g., as concerns about falling or low fall-related selfefficacy. It is common in people with Parkinson's disease (PD), and there is growing knowledge about its contributing factors. However, previous multivariate studies have mainly focused on fear of falling in relation to PD-related disabilities, and less is known about the associations between fear of falling and personal and environmental factors. Objective: To identify explanatory factors of concerns about falling in people with PD by focusing on personal and environmental factors as well as PD-related disabilities. Methods: Data were collected from 241 persons with PD (39% women, median age 70 years, PD duration 8 years). Concerns about falling (assessed with the Falls Efficacy Scale-International, FES-I; categorized into low, moderate, or high concerns) were used as the dependent variable in a multivariate ordinal regression analysis. Personal factors, environmental factors and PD-related disabilities constituted independent variables. Results: Low, moderate and high concerns about falling were reported by 29%, 24% and 47% of the participants, respectively. Walking difficulties, orthostatism, motor symptoms, age, and fatigue (presented in order of importance) were significant (p < 0.05) explanatory factors of concerns about falling. Conclusions: Several factors significantly explained concerns about falling in people with PD. Walking difficulties was by far the strongest explanatory factor. This suggests that minimizing walking difficulties should be a primary target when aiming at reducing concerns about falling in people with PD.

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“…Previous studies on energy costs in clinical populations have been focused on maximal tests, which provide valuable information but do not reflect the needs of the patient on a day-to-day basis. The only recent study which assessed walking economy in PD patients at slow velocities [8,9] used fixed incremental speeds on a treadmill walk (which has shown to be different from overground walking), and did not evaluate the self-selected speed.…”

Section: Introductionmentioning

confidence: 99%

Energy cost of spontaneous walking in Parkinson’s disease patients

et al. 2011

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In healthy subjects, comfortable walking minimizes the energy cost (E (c)) of locomotion. In Parkinson's disease (PD) patients walking is slower than in healthy subjects: this may increase E (c). Our aims were to analyze gait and E (c) in PD patients during walking, particularly at self-selected speed, and the possible pathological, mechanical, and cardiorespiratory limitations. Fourteen mild-to-moderate PD and 14 control subjects were enrolled. Subjects underwent 5-min walking tests at two speeds: self-selected and as-fast-as-possible speeds. Cardiopulmonary and gait parameters (heart rate, ventilation, gas exchanges, step count) were recorded. Velocity was reduced in PD compared to control subjects at both speeds (P < 0.05), and PD patients had shorter strides (P < 0.05) at both speeds and reduced cadence (P = 0.01) at fastest speed. No significant difference was found in E (c) at self-selected (0.12 ± 0.04 versus 0.11 ± 0.02 mLO(2) kg(-1) m(-1) in PD and control subjects, respectively) and maximal (0.14 ± 0.03 versus 0.15 ± 0.02 mLO(2) kg(-1) m(-1) in PD and control subjects, respectively) speed. However, the E (c) increment from self-selected to fastest velocity was significantly lower (P = 0.02) in PD patients. PD patients failed to walk at a self-selected speed, which minimizes the E (c). This could be mainly due to the inability to develop a wider stride. Cardiorespiratory adaptation was not affected, except for the possible reduced cardiac adaptation observed in some (28%) cases. Presumably, rehabilitation procedures that improve flexibility and step length may help maintain walking ability.

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Walking economy in people with Parkinson's disease

Cited by 87 publications

References 45 publications

Factors Contributing to Perceived Walking Difficulties in People with Parkinson’s Disease

Factors Contributing to Perceived Walking Difficulties in People with Parkinson’s Disease

Concerns About Falling in Parkinson’s Disease: Associations with Disabilities and Personal and Environmental Factors

Energy cost of spontaneous walking in Parkinson’s disease patients

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