Objective: To describe clinical, electromyographic, and gait kinematic parameters throughout Parkinson’s disease (PD) progression

Background: PD is the second most prevalent neurodegenerative disease worldwide. Classic motor symptoms such as tremors and bradykinesia appear early. In advanced stages, gait disturbances and postural control deficits compromise independence. Pharmacological treatment becomes less effective, increasing the importance of physiotherapy. PD present heterogeneous clinical manifestations, with a need to characterize all types of patients in detail. Clinical assessments may be complemented with an instrumented evaluation of gait to detect early abnormalities and implement appropriate medical and physical interventions.

Method: A descriptive observational study was conducted with 32 PD patients (ages 50–83, 13 female). Sociodemographic data (age, sex, weight, height, disease duration, medication, and Levodopa Equivalent Daily Dose) were collected via self-report. Participants were classified by Hoehn and Yahr (HY) stage. Functional Independence Measure (FIM), Montreal Cognitive Assessment (MoCA), and Freezing of Gait Questionnaire (FOG-Q) were performed. Gait kinematics assessments were performed using infrared cameras for 3-dimensional motion capture (VICON T-10s) and Delsys Trigno electromyography sensors were used on lower limbs muscles according to SENIAM guidelines. Data and statistical analyses were conducted using Matlab 9.1.0 (R2016b). Kruskal-Wallis, Wilcoxon and permutation tests were applied with the corresponding corrections for multiple comparisons. All analyses were focused on the most affected limb. This study was approved by the Scientific Ethics Committee of the Los Ríos Health Service, Chile

Results: The clinical characteristics and temporal patterns of electromyographic activity of the lower limb muscles were modified in relation to the progression of the disease as well as kinematic variables: step speed, step length, support time and percentage of walking in foot-off

Conclusion: Patients in 3 and 4 HY stages require higher doses of dopaminergic medication, but this does not mean improvements in the gait as they walk more slowly, with shorter and shuffling steps, which increases the risk of falls. On the other hand, as the disease progresses, the activation patterns of the thigh and leg muscle groups are modified, which limits mobility, preserving functional impairment

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MDS Abstracts - https://www.mdsabstracts.org/abstract/functional-and-biomechanical-characterization-through-the-progression-of-parkinsons-disease/