Objective: This cross-sectional study aimed to evaluate the effect of imposed faster and slower walking speeds on gait rhythmicity in people with Parkinson’s disease (PD) with a history of falls.

Background: Symptoms of postural instability and gait disability increase the risk of falls for people with PD and are not always well managed with traditional therapies. Treadmill-based gait training has emerged as a common therapy for managing gait impairments and systematic evidence shows that it is effective at improving stride length, walking speed and walking distance. However, measures of local stability indicate that stability is improved at slower walking speeds, suggesting that some patients may walk slower to maximise their safety. As such, there is a need to better understand how increasing one’s walking speed impacts their postural stability and risk of future falls.

Methods: Twenty people with PD (10 with a history of falls; 10 without) and 10 age- and gender-matched controls completed a series of validated tests to determine their medical history, balance confidence, history of falls and symptom severity. Walking stability was assessed on a treadmill at 70%, 100% and 130% of each participant’s preferred walking speed using two wireless accelerometers positioned on the head and trunk. Raw head and trunk accelerations were processed to calculate the harmonic ratios (HRs) and root mean square (RMS) accelerations, which assessed rhythmicity and movement amplitude, respectively.

Results: Linear mixed model analyses indicated that PD fallers had lower head and trunk HRs than the PD and age-matched controls, while PD controls also had lower head and trunk HRs than age-matched controls. Group*Intensity interactions indicated that while the PD and age-matched controls systematically increased their head and trunk rhythmicity from the 70% to 130% conditions, head and trunk rhythmicity was not improved at faster speeds for PD fallers. Anteroposterior RMS accelerations were also greater for PD fallers compared with both control groups and Group*Intensity interactions indicated that vertical head and trunk accelerations increased systematically from the 70% to 130% speeds for both control groups, but not for PD fallers.

Conclusions: These results suggest that improved temporospatial gait characteristics do not necessarily represent improved walking stability and this must be considered when rehabilitating gait in people with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effect-of-walking-speed-on-postural-stability-in-parkinsons-disease-fallers/