Perceived walking difficulties in Parkinson’s disease – predictors and changes over time
Abstract Background People with Parkinson’s disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties. Methods 149 people with PD (mean age 67.9 years) completed the Walk-12G questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties. Results Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.7 versus 18.6, p < 0.001. Concerns about falling was the strongest predictor (β = 0.467) of perceived walking difficulties, followed by problems maintaining balance while dual tasking (β = 0.265), pain (β = 0.137) and postural instability (β = 0.116). Problems maintaining balance while dual tasking was the strongest predictor (β = 0.180) of a change in perceived walking difficulties, followed postural instability (β = 0.098). Conclusions Perceived walking difficulties increase over time in people with PD. The predictive factors identified in this study (concerns about falling, problems maintaining balance while dual tasking, pain, postural instability) are modifiable. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.