Objective: We investigated whether: 1) gait in daily life differs in people with Parkinson’s disease (PD) compared to healthy controls (HC), and 2) the length of the gait bout influences such difference.

Background: Wearable technology has the potential to quantify mobility function outside the laboratory during daily life. Measures of walking abilities in a natural environment are thought to reflect functional mobility better than a single test in the clinic, where increased attention could enhance motor performance. Research in the past decade has been focusing on this topic, but when measuring walking at home, it is still unclear whether to include all bouts or to select gait bouts of particular lengths, when comparing the quality of gait between groups.

Method: We recruited 17 people with a mild-moderate idiopathic PD (66.2±4 years), and 19 age-matched HC subjects (67±7.4 years) to date. Subjects wore 3 inertial sensors (Opals, APDM) attached to both feet and the lumbar region for 7 days of continuous monitoring. A gait bout was defined as walking bouts of at least 3 consecutive steps, a minimum duration of 3 seconds and a step-to-step duration of no longer than 2.5 seconds. We derived a total of 60 gait metrics, including mean and coefficient of variability (CV) of each gait metric. We categorized each bout into four sizes based on a number of strides:  small (1-10 strides), medium (11-30 strides), large (31-60 strides) and very large (>60 strides) bouts, respectively. We calculated the ‘effect size’ to separate PD from control gait characteristics using Cohen’s d.

Results: The majority (>85%) of the detected gait bouts were of small and medium size, reflecting natural behavior in daily life for people with PD and HC.  The number of metrics with the large effect size (>0.8) to separate PD from HC gait was 22/60 for the small bouts, 9/60 for the medium bouts, 15/60 for the large bouts, and 15/60 for the very large bouts. Further, most gait metrics with large effect size were related to the variability of gait, such as CV of stance time, pitch of the foot at toe-off, and single limb support time.

Conclusion: Our preliminary findings suggest that small, large, and very large gait bout size were more impaired in PD compared to HC. Further investigation of the effects of bout size on a large dataset is required to understand mobility in daily life and to use as outcome measures for clinical trials.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/does-gait-in-real-life-differ-between-people-with-parkinsons-disease-and-healthy-controls/