Objective: The purpose of this study is to establish gait references in a large cohort of essential tremor (ET) patients. We analyzed the spatial temporal gait data through our database, specifically focusing on age, gender, disease duration, and the performance subscale of The Essential Tremor Rating Assessment Scale (TETRAS). The goal is to establish a new baseline database for ET patients and investigate associations between gait characteristics and demographic factors.

Background: Essential tremor is the most common movement disorder in adults worldwide [1]. While tremor is its hallmark feature, ET is associated with other motor impairments, including under-recognized gait deficits [2]. Large-scale studies examining gait in ET clinic patients remain rare.

Method: This retrospective study analyzed gait variables from moderate-to-advanced ET patients undergoing surgical evaluation who had 3D gait motion analysis between 7/2008 and 7/2024. Standard gait testing protocol included walking straight, with and without turns (≥5 cycles). Mean and standard deviation statistics were calculated for eight separate spatiotemporal gait parameters stratified by sex, age, and disease duration. Variation in gait outcomes with study variables were assessed with separate univariate ANOVAs.

Results: The study included N=324 patients (60% male), with a mean age of 69±11 years and a mean disease duration of 23±17 years. In a subset of patients, the average TETRAS performance subscale score was 27.1±7.6. Multiple gait outcomes declined with age (speed, p < 0.01; stride length, p < 0.01), with more pronounced declines in men than women. Notably, gait speed decreased from 100.3 cm/s in patients under 50 years to 74.3 cm/s in those over 80 years. No significant associations between gait outcomes and disease duration were identified. In contrast, 6 of 8 gait outcomes (stride length, velocity, swing phase, total, single and initial double support time) declined significantly (p < 0.01) with increasing TETRAS performance subscale score (Figure 01).

Conclusion: This study establishes gait references in ET, revealing significant age- and severity-related impairments. Gait declines with increasing TETRAS scores but not disease duration, emphasizing the need for gait assessment in ET management. These findings enhance patient care by improving prognosis and pave the way for future studies on gait changes following surgical interventions.

Velocity significantly declined with higher TETRAS

References: 1- Louis Ed, Ferreira JJ. How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor. Mov Disord 2010;25:534.

2- Stolze H, Petersen G, Raethjen J. et al. The gait disorder of advanced essential tremor. Brain. 2001 Nov;124(Pt 11):2278-86. doi: 10.1093/brain.124/11/2278.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/spatiotemporal-gait-norms-in-essential-tremor/