Objective: To compare quantitative spatiotemporal and plantar pressure gait parameters between patients with Parkinson’s disease (PD) and atypical parkinsonian syndromes (APS) using instrumented gait analysis.

Background: Gait disturbance is a prominent and disabling manifestation of PD. APS frequently present with gait abnormalities that overlap clinically with PD. Previous studies using quantitative gait analysis have demonstrated differences between PD and APS in parameters such as gait speed, stride variability, and postural instability. However, additional objective data from instrumented gait and plantar pressure systems may further characterize gait patterns in these disorders within routine clinical settings.

Method: This retrospective cohort study included 40 patients who underwent instrumented gait analysis at King Chulalongkorn Memorial Hospital between January 2021 and December 2025. Diagnoses were established by movement disorder specialists according to Movement Disorder Society (MDS) clinical diagnostic criteria. Spatiotemporal and plantar pressure parameters were recorded using the Strideway® System under a standardized walking protocol. Key gait variables included step width, stride velocity, double-support time, heel contact time, and plantar pressure metrics. Between-group comparisons were performed using appropriate statistical tests.

Results: Demographic characteristics are summarized in Table 1, and quantitative gait parameters are presented in Table 2. Step width was significantly wider in patients with APS compared with those with PD (13.98 ± 5.58 vs 10.58 ± 2.97 cm; p = 0.021). Descriptive trends suggested slower stride velocity, longer double-support time, prolonged heel contact time, lower maximum peak plantar pressure, and higher force–time integral in APS compared with PD. A schematic summary of gait parameter characteristics distinguishing PD and APS is illustrated in Figure 1.

Conclusion: Patients with APS demonstrated wider step width compared with those with PD, reflecting greater mediolateral instability. Instrumented gait analysis may provide objective metrics that support clinical judgement when differentiating parkinsonian syndromes. Larger prospective studies with subtype-specific analyses and adjustment for potential confounders are needed to clarify the role of quantitative gait analysis in differentiating parkinsonian disorders.

Table 1

Table 2

Figure 1

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