Backward Gait Dynamics More Impaired in Patients With Parkinson

Parkinson’s disease (PD) is often characterized by increases in the stride-to-stride variability; a recent study investigated whether gait parameters were implicated in motor symptoms or the risk of falling, fining that backward gait (BG) dynamics were more impaired in patients with de novo PD.

The study, published by the Journal of Clinical Neurology, evaluated demographic and clinical characteristics, such as the Fear of Falling Measure (FFM), in patients with de novo PD and in healthy subjects. Then, a computerized gait analysis was conducted using the GAITRite system for forward gate, BG, and dual-task gait (DG). In order to measure PD, the Unified Parkinson’s Disease Rating Scale Part III was used.

“Most gait studies have investigated patients in the advanced stages of PD rather than the early stages of PD, because alterations of gait parameters are closely related to the progression of motor symptoms in PD patients. This focus has resulted in a dearth of information on the characteristics of gait dynamics in early-stage PD,” the authors said. “However, some researchers have reported that even patients with de novo PD exhibited a slow gait with reductions in stride length and stride time.9,10 Our group recently showed that the slow gait in patients with de novo PD was related to a reduction in the stride length rather than the stride time.”

In total, 24 patients with de novo PD and 27 controls were included in the study. Patients with de novo PD demonstrated a slower gait and shorter stride in all 3 gaits, when compared with the controls. Additionally, those with de novo PD also showed increased in the stride-to-stride variability in the stride time and stride length of the gait for BG, increased length for DG, and no increase for FG, according to the results.

The researchers emphasized that BG speed in de novo PD patients was significantly associated with their motor symptoms yet negatively correlated to the FFM score.

“Patients with de novo PD exhibited a slower gait and shorter stride in FG, BG, and DG compared with normal controls. However, the stride-to-stride gait variability was more impaired in BG than in FG or DG,” the authors stated. “Furthermore, the BG speed was more closely related to motor symptoms and fear of falling than were the FG and DG speeds in patients with de novo PD.”

The authors concluded that more clinically relevant studies of BG are necessary in patients with PD in the future.

Reference

Kwon K, Park S, Lee H, et al. Backward gait is associated with motor symptoms and fear of falling in patients with de novo Parkinson’s disease [published online August 23, 2019]. Journal of Clinical Neurology. http://dx.doi.org/10.3988/jcn.2019.15.4.473