Objective: The purpose of this study was to analyze the correlation between disease severity and variable by using spatio-temporal and kinematic variables during forward and backward walking according to severity of disease.

Background: Gait disorders in Parkinson’s disease (PD) are considered the most common motor-related disorder [1]. Extremely debilitating gait may be lead to loss of independence and increased falls in PD patients [2,3]. Forward and backward walking in PD patients has been investigated in a few previous studies. However, the analysis of forward and backward gait has been limited [4,5], and it was rather difficult to identify the clear differences between the groups according to severity of PD symptoms.

Methods: A total of 62 PD patients participated in this study. The group of PD patients was divided to 21 patients H&Y 3.0 PD, 16 patients H&Y 2.5 PD, and 25 patients H&Y stage 2.0 PD(Table 1). PD patients were tested in an off-medication state, after abstaining from anti-Parkinsonism medications for a minimum of 12 hours prior to the trial. The forward and backward walking test was captured by 6 infrared cameras (Vicon, MX-T10, UK) on an 8-meter walkway. All statistical analyses were performed using SPSS (version 21.0, SPSS Inc, Chicago, IL). For the association of Hoehn and Yahr scale and spatio-temporal variable and kinematic variable during forward and backward walking of MAS step, Pearson correlation coefficient was used. Significance was set at p < 0.05.

Results: For the forward walking, H&Y scores were correlated with step time(r=0.319, p=0.011), stride time(r=0.380, p=0.002), and asymmetry index of step length(r=0.265, p=0.038), step length(r=-0.491, p<0.000), stride length(r=-0.528, p<0.000), walking speed(r=-0.556, p<0.000), and toe clearance height(r=-0.544, p<0.000). For the backward walking, H&Y scores were correlated with asymmetry index of step length(r=0.369, p=0.003) step length(r=-0.461, p<0.000), stride length(r=-0.479, p<0.000), walking speed(r=-0.471, p<0.000), toe clearance height(r=-0.362, p=0.004), and ROM of hip joint(r=-0.348, p=0.006) and ankle joint(r=-0.439, p<0.000) (Table 2).

Conclusions: In conclusion, we could confirm the higher the H&Y score, the lower the performance in the forward and backward gait. Therefore, the forward and backward walking of the PD patients was a useful task in detecting the severity of the PD. It also might be helpful to understand the physiology of PD patients. Furthermore, these results might suggest that forward and backward walking might be helpful for measurement and analysis of gait characteristics in PD.

References: [1] Lo´ pez IC, Ruiz PJG, del Pozo SVF, Bernardos VS. Motor complications in Parkinson’s disease: ten year follow-up study. Movement Disorders 2010; 25(16):2735–9. [2] Boonstraa TA, Kooij Hvd, Munnekea M, Bloema BR. Gait disorders and balance disturbances in Parkinson’s disease: clinical update and pathophysiology. Current Opinion in Neurology 2008;21:461–71. [3] Tseng, J., Jeng, C., & Yuan, R. Y. (2012). Comparisons of forward and backward gait between poorer and better attention capabilities in early Parkinson’s disease. Gait & posture, 36(3), 367-371. [9] Bryant, M. S., Rintala, D. H., Hou, J. G., Lai, E. C., & Protas, E. J. (2011). Effects of levodopa on forward and backward gait patterns in persons with Parkinson’s disease. NeuroRehabilitation, 29(3), 247-252. [10] Hackney, M. E., & Earhart, G. M. (2009). Backward walking in Parkinson’s disease. Movement Disorders, 24(2), 218-223.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/correlation-between-severity-of-disease-spatio-temporal-variables-and-kinematic-variables-during-forward-and-backward-walking/