Objective: To examine the associations between retro walking and frailty parameters such as low grip strength, exhaustion, low physical activity and weight loss and compare this to other gait and mobility conditions in PD.

Background: Advancing Parkinson’s disease (PD) is not only associated with increasingly levodopa refractory postural instability and gait difficulties (PIGD) but also physical frailty. Increasing evidence suggests alternative pathophysiologies underlying physical frailty and gait beyond the pure peripheral deconditioning effects of sedentariness. The effects of physical frailty may become more manifest in challenged gait conditions such as retro walking that not only results in compromised multisensory and cognitive processing functions but also relies on different muscular gait activation patterns.

Method: 81 PD patients underwent mobility tests and frailty assessments. Retro walking, forward walking, the Timed Up and Go (TUG) test, and dual-task TUG were assessed for slowness. Frailty phenotypes were evaluated as follows: grip strength for weakness, spirometry for exhaustion, the Global Physical Activity Questionnaire for low physical activity, and body composition analysis for weight loss. Within group correlational analyses were performed between the different gait measures and the individual and summed frailty measures in the PD patients. Additionally, post hoc biomechanistic sensitivity analyses were made between PD patients with and without impaired balance.

Results:

In the PD group, correlation analysis identified retro walking as the frailty phenotype most strongly associated with the other four frailty components (grip strength: r = -0.295, p = 0.034; moderate-intensity activities: r = -0.449, p = 0.019; muscle lean mass: r = -0.320, p = 0.006; and inspiratory capacity: r = -0.376, p = 0.029). All mobility tests effectively differentiated PD patients with impaired balance from those without.

Conclusion: Retro walking reflects slowness and correlates with other frailty phenotype components, including weakness, exhaustion, low physical activity, and weight loss. Its unique compromised multisensory and cognitive processing functions and different muscular gait activation pattern highlights its value as a practical tool for early-stage frailty screening in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/retro-walking-a-potential-indicator-of-physical-frailty-in-parkinsons-disease/