Objective: The aim of this study was threefold: (1) to evaluate patients’ awareness and use of various compensation categories for gait impairments in PD; (2) to examine the patient-rated efficacy of compensation strategies, and whether this efficacy is context-dependent; and (3) to explore potential differences in the efficacy of the various compensation strategies between subgroups based on sex, age, disease duration and freezing status.

Background: Gait impairments are common and disabling in persons with Parkinson’s disease (PD). The application of compensation strategies helps to overcome these gait deficits. A framework of seven categories of compensation categories was recently published to capture the myriad of available compensation strategies.[1] Clinical observations suggest that the efficacy of the different categories of compensation strategies may vary depending on both individual patient characteristics and the context in which the strategies are applied. This variability has never been investigated in a systematic manner, hampering the ability of clinicians to provide a more tailored, personalized approach to gait rehabilitation for persons with PD.

Method: A survey was conducted among 4,324 adults with PD and self-reported disabling gait impairments.

Results: The main findings are: (1) compensation strategies for gait impairments are commonly used by persons with PD, but their awareness of the full spectrum of available strategies is limited; (2) the patient-rated efficacy of compensation strategies is high, but varies depending on the context in which the strategies are applied; and (3) compensation strategies are useful for all types of PD patients, but the efficacy of the different strategies varies per person.

Conclusion: The present findings support the application of compensation strategies for gait impairments in PD. Persons with PD should be – and wish to be – more thoroughly informed about the full spectrum of available compensation strategies. Our results also emphasize that a one-size-fits-all approach to gait rehabilitation is inappropriate. The choice of compensation strategies should be tailored to the personal needs of the individual patient, as well as to the context in which the application of a compensation strategy is necessary.

References: [1] Nonnekes J, Ruzicka E, Nieuwboer A, Hallett M, Fasano A, Bloem BR. Compensation Strategies for Gait Impairments in Parkinson Disease: A Review. JAMA Neurol. 2019;76(6):718-725.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/compensation-strategies-for-gait-impairment-in-parkinsons-disease-a-survey-among-4324-patients/