Corelation of gait parameters, cognitive impairment and brain atrophy in patients with Parkinson’s disease and the «normally aging population»

2021 ◽  
Author(s):  
P. Y. Diachenko ◽  
I. I. Leta ◽  
G. S. Moskovko
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Function ◽  
Brain Atrophy ◽  
Stride Length ◽  
Aging Population ◽  
Step Length ◽  
Normal Aging ◽  
Gait Velocity ◽  
Gait Parameters

Objective — to identify the most significant markers of gait that indicate a decrease in cognitive function based on investigation of the corelation of cognitive impairment, gait parameters and atrophy of brain structures in groups of patients with Parkinson’s disease and the «normally aging population». Methods and subjects. 66 subjects were examined: 30 patients with Parkinson’s disease (mean age 54.9 ± 5.9, 50 % men) and 33 without neurological pathology (mean age 52.7 ± 7.6, 66 % men). All of them underwent neurological examination, assessment of temporal and spatial gait parameters using the GaitRite system, grading of brain atrophy using a comprehensive visual rating scale of MRI scans and assessment of cognitive status using the Montreal Cognitive Assessment Scale. Results. Cognitive performance was significantly lower in the subgroup of patients with Parkinson’s disease compared to the subgroup of «normally aging population». The gait profile of patients with Parkinson’s disease significantly differed from the gait profile of individuals from the «normal aging» subgroup by slower gait velocity, shorter step length and stride length for both limbs. The gait parameters, which showed a strong correlation with cognitive tests, differed in the subgroups, but gait velocity, stride length and step length for both extremities were common among them. These common gait parameters showed a strong direct correlation with brain atrophy in the subgroup of patients with Parkinson’s disease, but only velocity correlated with atrophy in the subgroup of «normal aging» among all of them. It was determined by the method of multiple regression analysis that it was precisely the atrophy of the brain that turned out to be the most influential factor in the decrease in cognitive function in the general group and subgroups. Conclusions. The gait profile in Parkinson’s disease subgroup is characterized by lower velocity, shorter step length, stride length for both limbs and significantly differs from the subgroup of «normal aging». These changes are a consequence of the influence of the disease on the motor sphere. Velocity showed a strong correlation in both subgroups not only with cognitive abilities, but also with cerebral atrophy. This confirms the hypothesis about the possibility of using gait velocity as a universal sensitive marker for current and longitudinal assessment of cognitive function, especially in clinical practice.  

scholarly journals Clinical Relevance of Standardized Mobile Gait Tests. Reliability Analysis Between Gait Recordings at Hospital and Home in Parkinson’s Disease: A Pilot Study

2020 ◽  
Vol 10 (4) ◽  
pp. 1763-1773
Author(s):  
Heiko Gaßner ◽  
Philipp Sanders ◽  
Alisa Dietrich ◽  
Franz Marxreiter ◽  
Bjoern M. Eskofier ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Reliability Analysis ◽  
Clinical Relevance ◽  
Stride Length ◽  
Standardized Test ◽  
Gait Velocity ◽  
Gait Parameters ◽  
At Home

Background: Gait impairments in Parkinson’s disease (PD) are quantified using inertial sensors under standardized test settings in the hospital. Recent studies focused on the assessment of free-living gait in PD. However, the clinical relevance of standardized gait tests recorded at the patient’s home is unclear. Objective: To evaluate the reliability of supervised, standardized sensor-based gait outcomes at home compared to the hospital. Methods: Patients with PD (n = 20) were rated by a trained investigator using the Unified Parkinson Disease Rating Scale (UPDRS-III). Gait tests included a standardized 4×10 m walk test and the Timed Up and Go Test (TUG). Tests were performed in the hospital (HOSPITAL) and at patients’ home (HOME), and controlled for investigator, time of the day, and medication. Statistics included reliability analysis using Intra-Class correlations and Bland-Altman plots. Results: UPDRS-III and TUG were comparable between HOSPITAL and HOME. PD patients’ gait at HOME was slower (gait velocity Δ= –0.07±0.11 m/s, –6.1%), strides were shorter (stride length Δ= –9.2±9.4 cm; –7.3%), and shuffling of gait was more present (maximum toe-clearance Δ= –0.7±2.5 cm; –8.8%). Particularly, narrow walkways (<85 cm) resulted in a significant reduction of gait velocity at home. Reliability analysis (HOSPITAL vs. HOME) revealed excellent ICC coefficients for UPDRS-III (0.950, p < 0.000) and gait parameters (e.g., stride length: 0.898, p < 0.000; gait velocity: 0.914, p < 0.000; stance time: 0.922, p < 0.000; stride time: 0.907, p < 0.000). Conclusion: This pilot study underlined the clinical relevance of gait parameters by showing excellent reliability for supervised, standardized gait tests at HOSPITAL and HOME, even though gait parameters were different between test conditions.

Quantitative Gait Analysis Using a Pose-Estimation Algorithm with a Single 2D-Video of Parkinson’s Disease Patients

2021 ◽  
pp. 1-13
Author(s):  
Jung Hwan Shin ◽  
Ri Yu ◽  
Jed Noel Ong ◽  
Chan Young Lee ◽  
Seung Ho Jeon ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pose Estimation ◽  
Estimation Algorithm ◽  
Step Length ◽  
Video Tracking ◽  
Gait Velocity ◽  
Gait Parameters ◽  
Validation Experiment ◽  
Time Required

Background: Clinician-based rating scales or questionnaires for gait in Parkinson’s disease (PD) are subjective and sensor-based analysis is limited in accessibility. Objective: To develop an easily accessible and objective tool to evaluate gait in PD patients, we analyzed gait from a single 2-dimensional (2D) video. Methods: We prospectively recorded 2D videos of PD patients (n = 16) and healthy controls (n = 15) performing the timed up and go test (TUG). The gait was simultaneously evaluated with a pressure-sensor (GAITRite). We estimated the 3D position of toes and heels with a deep-learning based pose-estimation algorithm and calculated gait parameters including step length, step length variability, gait velocity and step cadence which was validated with the result from the GAITRite. We further calculated the time and steps required for turning. Then, we applied the algorithm to previously recorded and archived videos of PD patients (n = 32) performing the TUG. Results: From the validation experiment, gait parameters derived from video tracking were in excellent agreement with the parameters obtained with the GAITRite. (Intraclass correlation coefficient > 0.9). From the analysis with the archived videos, step length, gait velocity, number of steps, and the time required for turning were significantly correlated (Absolute R > 0.4, p < 0.005) with the Freezing of gait questionnaire, Unified PD Rating scale part III total score, HY stage and postural instability. Furthermore, the video-based tracking objectively measured significant improvement of step length, gait velocity, steps and the time required for turning with antiparkinsonian medication. Conclusion: 2D video-based tracking could objectively evaluate gait in PD patients.

scholarly journals Gait and Balance Changes with Investigational Peripheral Nerve Cell Therapy during Deep Brain Stimulation in People with Parkinson’s Disease

2021 ◽  
Vol 11 (4) ◽  
pp. 500
Author(s):  
Geetanjali Gera ◽  
Zain Guduru ◽  
Tritia Yamasaki ◽  
Julie A. Gurwell ◽  
Monica J. Chau ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Peripheral Nerve ◽  
Brain Stimulation ◽  
Step Length ◽  
Gait Velocity ◽  
Balance Performance ◽  
Improved Performance ◽  
Deep Brain

Background: The efficacy of deep brain stimulation (DBS) and dopaminergic therapy is known to decrease over time. Hence, a new investigational approach combines implanting autologous injury-activated peripheral nerve grafts (APNG) at the time of bilateral DBS surgery to the globus pallidus interna. Objectives: In a study where APNG was unilaterally implanted into the substantia nigra, we explored the effects on clinical gait and balance assessments over two years in 14 individuals with Parkinson’s disease. Methods: Computerized gait and balance evaluations were performed without medication, and stimulation was in the off state for at least 12 h to best assess the role of APNG implantation alone. We hypothesized that APNG might improve gait and balance deficits associated with PD. Results: While people with a degenerative movement disorder typically worsen with time, none of the gait parameters significantly changed across visits in this 24 month study. The postural stability item in the UPDRS did not worsen from baseline to the 24-month follow-up. However, we measured gait and balance improvements in the two most affected individuals, who had moderate PD. In these two individuals, we observed an increase in gait velocity and step length that persisted over 6 and 24 months. Conclusions: Participants did not show worsening of gait and balance performance in the off therapy state two years after surgery, while the two most severely affected participants showed improved performance. Further studies may better address the long-term maintanenace of these results.

scholarly journals Quantitative assessment of gait parameters in people with Parkinson's disease in laboratory and clinical setting: Are the measures interchangeable?

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Massimiliano Pau ◽  
Federica Corona ◽  
Roberta Pili ◽  
Carlo Casula ◽  
Marco Guicciardi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Setting ◽  
Stride Length ◽  
Experimental Setting ◽  
Optoelectronic System ◽  
Double Support ◽  
Gait Parameters ◽  
Spatio Temporal ◽  
Wearable Accelerometers

This study aimed to investigate possible differences in spatio-temporal gait parameters of people with Parkinson’s Disease (pwPD) when they are tested either in laboratory using 3D Gait Analysis or in a clinical setting using wearable accelerometers. The main spatio-temporal gait parameters (speed, cadence, stride length, stance, swing and double support duration) of 31 pwPD were acquired: i) using a wearable accelerometer in a clinical setting while wearing shoes (ISS); ii) same as condition 1, but barefoot (ISB); iii) using an optoelectronic system (OES) undressed and barefoot. While no significant differences were found for cadence, stance, swing and double support duration, the experimental setting affected speed and stride length that decreased (by 17% and 12% respectively, P<0.005) when passing from the clinical (ISS) to the laboratory (OES) setting. These results suggest that gait assessment should be always performed in the same conditions to avoid errors, which may lead to inaccurate patient’s evaluations.

Gait velocity and step length at baseline predict outcome of Nordic walking training in patients with Parkinson's disease

2015 ◽  
Vol 21 (4) ◽  
pp. 413-416 ◽  
Author(s):  
Manon Herfurth ◽  
Jana Godau ◽  
Barbara Kattner ◽  
Silvia Rombach ◽  
Stefan Grau ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Step Length ◽  
Gait Velocity ◽  
Nordic Walking

scholarly journals Gait Training Methods and ChangesiIn Gait Parameters in Parkinson`s Disease (Literature Review)

2020 ◽  
Vol 2 (7) ◽  
Author(s):  
Aušra Stuopelytė ◽  
Rasa Šakalienė
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Step Length ◽  
Gait Training ◽  
Auditory Stimulation ◽  
Training Methods ◽  
Dual Tasking ◽  
Gait Parameters ◽  
Rhythmic Auditory Stimulation ◽  
Walking Velocity

Parkinson’s disease is a chronic progressive neurological disorder that can impact function to a variable degree. Changes in gait parameters are the most common signs of Parkinson’s disease. Patients with Parkinson’s disease walk with a reduced step length, step time, walking velocity and walking cadence, increased stride cycle time, coefficient of variation of the step amplitude and step time and increased risk to fall. So, various gait training methods are applied. The effect of rhythmic auditory stimulation on gait in Parkinson’s disease patients is analysed. We can use various kinds of music, metronome, scansion and clapping as a rhythmic auditory stimulation.One of gait training methods in Parkinson’s disease patients is treadmill training. There are attempts to combine treadmill training with transcranial magnetic stimulation and virtual reality. We can use Nordic walking method and because walking technique requires straight posture, trunk rotation, bigger step and heel stride. More often robot–assisted gait training is used in patients with Parkinson’s disease gait training. The effect of dual–tasking and walking with music methods for gait and balance training in patients with Parkinson’s disease is also analysed. This method requires participants to perform primary and secondary tasks at the same time. The secondary task can be cognitive or motor. Dual–tasking is widely analysed because opinions about applying this method are very controversial. Walking with music method is more often analysed in scientific literature. This method could not be compared to rhythmic auditory stimulation method because the latter requires precise walking to rhythm and walking with music method is oriented to emotional component (music is chosen according patients’ music taste). As these methods are applied, we can see an increase in chosen walking and maximal walking velocities, step length and time, distance covered, and decrease in the coefficient of variation of the step time and turning time.Keywords: Gait impairments, walking velocity, rhythmic auditory stimulation.

Immediate Effects of the Dorsiflexion Angle of Hinged Ankle-foot Orthosis on the Spatiotemporal Gait Parameters of Children With Spastic Cerebral Palsy

2021 ◽  
Author(s):  
IlHyun Son ◽  
GyuChang Lee
Keyword(s):  
Cerebral Palsy ◽  
Stride Length ◽  
Step Length ◽  
Gait Velocity ◽  
Spastic Cerebral Palsy ◽  
Spastic Diplegia ◽  
Ankle Foot Orthosis ◽  
Gait Parameters ◽  
Children With Cerebral Palsy ◽  
Foot Orthosis

Abstract Background: It has been reported the effects of a hinged ankle-foot orthosis on the gait ability of children with cerebral palsy. However, no studies investigated the effects of the dorsiflexion angle of the hinged ankle-foot orthosis on the spatiotemporal gait parameters of children with cerebral palsy. This study aimed to investigate the immediate effects of a 10° dorsiflexion inducing ankle-foot orthosis the spatiotemporal gait parameters of children with spastic diplegia compared to barefoot and a hinged ankle-foot orthosis.Methods: This study was cross-over design. 10 children with spastic diplegia were walked with barefoot, a hinged ankle-foot orthosis, and a 10° dorsiflexion inducing ankle-foot orthosis. GAITRite was used to collect the spatiotemporal gait parameters including gait velocity, cadence, step length, stride length, single leg support, and double leg support. Results: It showed that a 10° dorsiflexion inducing ankle-foot orthosis significantly improved the gait velocity, cadence, step length, stride length, single leg support, and double leg support than barefoot and a hinged ankle-foot orthosis (p<.05). Conclusion: The results of this study implied that a 10° dorsiflexion inducing ankle-foot orthosis could improve the gait ability of children with spastic diplegia more than barefoot or a hinged ankle-foot orthosis. High quality future studies will need to examine the effects of hinged ankle-foot orthosis on gait ability according to dorsiflexion angles.

scholarly journals Association of Gait Characteristics and Depression in Patients with Parkinson’s Disease Assessed in Goal-Directed Locomotion Task

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Péter Kincses ◽  
Norbert Kovács ◽  
Kázmér Karádi ◽  
Ádám Feldmann ◽  
Krisztina Dorn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Stride Length ◽  
Gait Pattern ◽  
Exact Nature ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Healthy Control ◽  
Affective Variables ◽  
Affective Disturbances

Introduction.In the genesis of Parkinson’s disease (PD) clinical phenomenology the exact nature of the association between bradykinesia and affective variables is unclear. In the present study, we analyzed the gait characteristics and level of depression in PD and healthy volunteers.Methods.Patients with PD (n=48) and healthy controls (n=52) were recruited for the present study. Walking speed, stride length, and cadence were compared between groups while participants completed a goal-directed locomotion task under visually controlled (VC) and visually noncontrolled conditions (VnC).Results.Significantly higher depression scores were found in PD comparing to healthy control groups. In PD, depression was associated with gait components in the VC wherein the place of the target was visible. In contrast, in healthy subjects the depression was associated with gait components in VnC wherein the location and image of the target were memorized and recalled. In patients with PD and depression, the visually deprived multitask augments the rate of cadence and diminishes stride length, while velocity remains relatively unchanged. The depression associated with gait characteristics as a comorbid affective factor in PD, and that impairs the coherence of gait pattern.Conclusion.The relationship between depression and gait parameters appears to indicate that PD not only is a neurological disease but also incorporates affective disturbances that associate with the regulation of gait characteristics.

scholarly journals Influence of Autocorrelated Rhythmic Auditory Stimulations on Parkinson’s Disease Gait Variability: Comparison With Other Auditory Rhythm Variabilities and Perspectives

2020 ◽  
Vol 11 ◽  
Author(s):  
Alexis Lheureux ◽  
Thibault Warlop ◽  
Charline Cambier ◽  
Baptiste Chemin ◽  
Gaëtan Stoquart ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Long Range ◽  
Coefficient Of Variation ◽  
Gait Speed ◽  
Step Length ◽  
Temporal Organization ◽  
Fluctuation Analysis ◽  
Gait Parameters ◽  
Stride Duration

Parkinson’s Disease patients suffer from gait impairments such as reduced gait speed, shortened step length, and deterioration of the temporal organization of stride duration variability (i.e., breakdown in Long-Range Autocorrelations). The aim of this study was to compare the effects on Parkinson’s Disease patients’ gait of three Rhythmic Auditory Stimulations (RAS), each structured with a different rhythm variability (isochronous, random, and autocorrelated). Nine Parkinson’s Disease patients performed four walking conditions of 10–15 min each: Control Condition (CC), Isochronous RAS (IRAS), Random RAS (RRAS), and Autocorrelated RAS (ARAS). Accelerometers were used to assess gait speed, cadence, step length, temporal organization (i.e., Long-Range Autocorrelations computation), and magnitude (i.e., coefficient of variation) of stride duration variability on 512 gait cycles. Long-Range Autocorrelations were assessed using the evenly spaced averaged Detrended Fluctuation Analysis (α-DFA exponent). Spatiotemporal gait parameters and coefficient of variation were not modified by the RAS. Long-Range Autocorrelations were present in all patients during CC and ARAS although all RAS conditions altered them. The α-DFA exponents were significantly lower during IRAS and RRAS than during CC, exhibiting anti-correlations during IRAS in seven patients. α-DFA during ARAS was the closest to the α-DFA during CC and within normative data of healthy subjects. In conclusion, Isochronous RAS modify patients’ Long-Range Autocorrelations and the use of Autocorrelated RAS allows to maintain an acceptable level of Long-Range Autocorrelations for Parkinson’s Disease patients’ gait.

Differential Gait Decline in Parkinson’s Disease Enhances Discrimination of Gait Freezers from Non-Freezers

2020 ◽  
Vol 10 (4) ◽  
pp. 1657-1673
Author(s):  
Aliyah Glover ◽  
Lakshmi Pillai ◽  
Shannon Doerhoff ◽  
Tuhin Virmani
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Regression Model ◽  
Stride Length ◽  
Freezing Of Gait ◽  
Binary Regression ◽  
Levodopa Dose ◽  
Gait Parameters ◽  
Neuroprotective Strategies ◽  
Change In Mean

Background: Freezing of gait (FOG) is a debilitating feature of Parkinson’s disease (PD) for which treatments are limited. To develop neuroprotective strategies, determining whether disease progression is different in phenotypic variants of PD is essential. Objective: To determine if freezers have a faster decline in spatiotemporal gait parameters. Methods: Subjects were enrolled in a longitudinal study and assessed every 3– 6 months. Continuous gait in the levodopa ON-state was collected using a gait mat (Protokinetics). The slope of change/year in spatiotemporal gait parameters was calculated. Results: 26 freezers, 31 non-freezers, and 25 controls completed an average of 6 visits over 28 months. Freezers had a faster decline in mean stride-length, stride-velocity, swing-%, single-support-%, and variability in single-support-% compared to non-freezers (p < 0.05). Gait decline was not correlated with initial levodopa dose, duration of levodopa therapy, change in levodopa dose or change in Montreal Cognitive Assessment scores (p > 0.25). Gait progression parameters were required to obtain 95% accuracy in categorizing freezers and non-freezers groups in a forward step-wise binary regression model. Change in mean stride-length, mean stride-width, and swing-% variability along with initial foot-length variability, mean swing-% and apathy scores were significant variables in the model. Conclusion: Freezers had a faster temporal decline in objectively quantified gait, and inclusion of longitudinal gait changes in a binary regression model greatly increased categorization accuracy. Levodopa dosing, cognitive decline and disease severity were not significant in our model. Early detection of this differential decline may help define freezing prone groups for testing putative treatments.

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