Objective: We investigated gait characteristics and contribution of clinical presentation and cognitive functioning to the gait characteristics in different Parkinson’s disease (PD) stages. Our aim was to elucidate relatively specific disease differences during disease progression in gait pattern. We compared clinical signs of PD stadiums and their correlation to gait characteristics.

Background: Gait alterations are observable phenomena in movement disorders patients. The impact of motor sign severity on gait performance and characteristics in PD has been well established. However, gait is not automated motor activity, even subtle cognitive disorders, most importantly in the domains of executive functions, are associated with a higher risk of falls and gait alterations in PD patients. Executive functioning is critical in complex gait situations, such as dual tasks performance while walking.

Method: PD patients (60 – 22F, 38M) performed demanding dual mental and motor tasks while walking on GAITRite electronic walkway carpet. Patients were chosen between three H&Y stage subgroups: H&Y 1, H&Y 2 and H&Y 3 – 20 patients in each group. Patients and 35 matched control subjects performed a basic walking task, a dual-motor task, a dual-mental task, and a combined motor and mental task while walking. Analyzed parameters were cycle time, stride length, swing time, double support time and variability of those four parameters.

Results: Results show significant impairment of temporal and spatial gait parameters in PD between stages of the disease. When PD patients were divided into subgroups, variability of gait was minor in subgroup H&Y 1, and more pronounced in later stages (H&Y 2), and further more in H&Y 3. Parameters become even more impaired during a simultaneous cognitive task. When the motor or combined tasks are performed, there is additional impairment of gait stability (significantly increased double support time).

Conclusion: It can be concluded that changes during disease progression point to gait and posture function disturbance. Further, particularly cognitive changes and behavioral symptoms and their changes during PD disease progression are correlated to gait function disturbances.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparison-of-gait-pattern-characteristics-during-parkinsons-disease-progression-analysis-of-gait-during-the-dual-task-walking/