Objective: Primary objective was to identify quantitative markers of gait impairment in patients with idiopathic Parkinson’s disease (IPD), atypical Parkinsonian disorders (APD) and healthy controls by using the automated, sensor-based gait analysis system (eGAIT – embedded gait analysis using IT). Secondary objective was to correlate eGAIT based gait signatures with clinical parameters of gait impairment in patients and controls.

Background: Gait impairment and consecutively reduced mobility are typical features of IPD and APD, including multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). Data on the quantitative and objective assessment of gait impairment in APD patients are not available but desirable as potential motor endpoints in treatment trials.

Methods: IPD and APD patients referred to the Movement Disorders Units in Innsbruck and Erlangen with a Hoehn and Yahr score (H&J) <=3 were recruited and underwent a clinical assessment, including validated rating scales. Objective gait analysis was performed by eGAIT consisting of inertial sensor units attached laterally to both shoes that provide spatiotemporal gait parameters including stride length and time, step cadence, heel-strike and toe-off angle, toe clearance, and gait speed (1).

Results: 17 patients with APD were compared to 17 age and HY matched patients with IPD, and to an age matched control group. We observed that the cadence (steps/min) was significantly lower in APD (51.9 ± 6.05) compared to IPD (57,3 ± 6.8; p=0,044). Also gait speed (m/s) was significantly lower in APD (IPD 1,20 ± 0,2 vs. APD 1,0 ± 0.22; p=0.018). Stride-length (m) was reduced in APD (115.75 ± 24,66) compared to IPD (128.82 ± 22.53). Also heel strike angle (IPD 13.9 ± 5.67 vs. APD 11.49 ± 5.87) and toe off angle (IPD 59.67 ± 10.95 vs. APD 55.78 ± 10.97) showed differences between the two groups, mirroring shuffling gait, that appeared more marked in APD patients. Every gait parameter was markedly impaired in patients compared to controls, showing that eGAIT was able to detect pathological gait signatures.

Conclusions: Our preliminary findings show that APD patients despite being matched for HY severity had more severely impaired gait parameters than IPD patients. Our data support that instrumented gait analysis could be an objective readout complementing therapy monitoring during clinical care, but also provide rater independent target parameters for clinical trials.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-cross-sectional-study-of-sensor-based-gait-analysis-in-atypical-parkinsonian-disorders/