Objective: In this study, we investigated how the association between gait during daily life and clinical measures changes with walking bouts of different lengths in people with Parkinson’s Disease (PD) and healthy controls (HC).

Background: Little is known about how walking characteristics differ by length of gait bouts during normal daily activities, or which gait bout lengths best reflect clinical measures of severity of PD, balance, and patient-related outcomes.

Method: So far, we have recruited 17 people with mild-moderate idiopathic PD (66.2±4.2 years), and 19 age-matched HC subjects (67±7.4 years). Subjects wore 3 inertial sensors (Opals, APDM) attached to both feet and the lumbar region for a week of continuous monitoring. A gait bout was defined as walking bouts of at least 3 consecutive steps, a minimum duration of 3 seconds and a step-to-step duration of no longer than 2.5 seconds. We derived a total of 60 gait metrics, including mean and variability of each gait metric. Clinical measures such as Activities-Specific Balance Confidence (ABC), Mini-BESTest (balance) and MDS-UPDRS Part III (34±11) were collected during a home visit. We categorized each bout into four groups based on a number of strides:  small (1-10 strides), medium (11-30 strides), large (31-60 strides) and very large (>60 strides) bouts.

Results: Preliminary analysis of continuous monitoring showed that the number of gait metrics that were significantly correlated with ABC (19/60) and Mini-BESTest (17/60) was higher for the small bout size compared to very large bout size (5/60 and 6/60, respectively). Most of these gait metrics were related to variability in spatiotemporal measures of gait. We also looked at the effect of bout length on gait metrics related to UPDRS III, PIGD and bradykinesia subscores in a subset of PD subjects (n=12, ON state). For small bout size, we found that variability in coronal range of trunk motion was correlated with UPDRS III (p=0.009); variability in maximum amount of lateral leg swing was correlated with PIGD (p=0.006); and variability in coronal trunk range of motion was correlated with bradykinesia (p=0.010).

Conclusion: Our results suggest that although the correlation between gait metrics for various bout size and clinical measures was statistically significant, more subjects are needed to determine which bout size reflects physician and patient assessments of mobility and motor signs of parkinsonism.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-between-gait-during-daily-life-and-clinical-measures-effects-of-bout-length/