Objective: Understanding gait abnormalities in moderate-to-advanced Parkinson’s disease (PD) is essential to enhance patient mobility and optimize clinical management [1]. This study aims to establish gait references in a large cohort of PD patients and examine how these references vary based on age, gender, disease duration, and clinical rating scales.

Background: Gait abnormalities are common in moderate-to-advanced PD, significantly affecting functional independence and fall risk [2]. Identifying key predictors of gait dysfunction and assessing treatment efficacy can improve clinical decision-making and patient outcomes. This study evaluates gait patterns in PD patients and examines the influence of demographic and disease-specific factors.

Method: This retrospective observational study analyzed gait variables from moderate-to-advanced PD patients undergoing surgical evaluation who underwent 3D gait motion analysis between 2/2019 and 7/2024. Patients arrived in the off-medication state.  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 sample was comprised of N=520 patients (72% male). Average age was 65±10 years and average disease duration was 10.2±5.6 years. Average MDS-UPDRS-III score (in a subset of patients) was 42.7±11.8. Multiple gait outcomes declined with age (speed, p<0.01; stride length, p<0.01), with stronger declines observed among women. In particular, gait speed declined from 86.9 to 69.3 cm/s from the fifth to ninth decades of life in PD. Although PD duration was not a particularly strong predictor of gait outcomes in our sample – with the largest associations representing only marginally significant (p=0.05) effects – MDS-UPDRS-III score was a strong predictor of gait quality, with 6/8 gait outcomes declining significantly with increasing MDS-UPDRS-III score (p<0.01).

Conclusion: Understanding predictors of gait dysfunction in PD may provide insights into disease progression and optimize therapeutic strategies. Identifying demographic and clinical factors influencing gait will contribute to personalized treatment approaches and improved mobility outcomes.

References: 1. Tripathi, R., McKay, J. L., & Esper, C. D. (2023). Use of 3D Motion Capture for Kinematic Analysis in Movement Disorders. Practical Neurology.
https://practicalneurology.com/articles/2023-dec/movement-disorders-moment-use-of-3d-motion-capture-for-kinematic-analysis-in-movement-disorders

2. Mirelman, A., Bonato, P., Camicioli, R., Ellis, T. D., Giladi, N., Hamilton, J. L., Hass, C. J., Hausdorff, J. M., Pelosin, E., & Almeida, Q. J. (2019). Gait impairments in Parkinson’s
disease. The Lancet Neurology, 18(7), 697–708. https://doi.org/10.1016/S1474-4422(19)30044-4

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MDS Abstracts - https://www.mdsabstracts.org/abstract/spatiotemporal-gait-norms-in-moderate-to-advanced-parkinsons-disease/