Objective: To explore the clinical relevance of upper limb coordination in PD, measured by wearable sensors, and quantified using continuous relative phase (CRP).
Background: Upper limb (UL) motor impairment in Parkinson’s disease (PD) substantially affects walking. Inter-arm coordination during walking is important to maintain dynamic balance and disruption of this may contribute to disease-related walking impairment in PD leading to falls. Wearable sensors offer a promising solution to accurately and unobtrusively capture upper limb coordination.
Method: Sixty-nine participants with PD from the OxQUIP study completed a two-minute walking task while wearing inertial measurement unit sensors on both wrists. UL clinical symptoms were assessed by summing the relevant MDS-UPDRS III components. CRP analysis was applied to wrist gyroscope data to quantify coordination between left and right arm swings. Kinematic outcomes included (a) mean absolute relative phase (MARP), reflecting average coordination pattern where a perfect anti-phase inter-arm movement demonstrates 180° phase shift, and (b) deviation phase (DPH), reflecting variability of inter-arm coordination across gait cycles. Associations between kinematic measures and clinical scores were assessed using Spearman’s rank correlation.
Results: Greater UL clinical severity was associated with more variable inter-arm coordination (DPH: p < 0.05), while no association was observed between clinical scores and MARP. Component-level analysis demonstrated significant associations between DPH and clinical gait impairment (p < 0.005), as well as postural tremor of both arms (p < 0.05).
Conclusion:
Greater variability of inter-arm coordination is associated with greater UL motor severity and specifically gait impairment in PD. This wearable-derived measure provides a clinically meaningful marker to assess UL and gait dysfunction, allowing monitoring of mobility and falls risk in PD patients.
To cite this abstract in AMA style:
P. Sharma, C. Sotirakis, P. Barmpas, N. Conway, J. Fitzgerald, C. Antoniades. Upper Limb Coordination During Walking is Associated with Clinical Severity in Parkinson’s Disease [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/upper-limb-coordination-during-walking-is-associated-with-clinical-severity-in-parkinsons-disease/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/upper-limb-coordination-during-walking-is-associated-with-clinical-severity-in-parkinsons-disease/