Objective: To determine if steady-state gait parameters in Parkinson disease (PD) patients could serve as a predictive biomarker for freezing of gait (FOG).

Background: FOG is a debilitating, late motor complication of PD that occurs in 50-80% of patients. It decreases mobility and increases falls thereby significantly worsening the quality of life. In separate studies, patients with FOG have been shown to have an increase in stride length variability, cadence, and asymmetry in stride.

Methods: PD patients and healthy controls (HC) were enrolled after IRB approval. Patients with more than 1 fall/day or a Montreal Cognitive Assessment (MoCA) score <10 were excluded. Subjects walked at their normal pace for 8 rounds on a 20×4 foot pressure-sensor mat (Zeno Walkway, Protokinetics, Havertown, PA). Data was collected and analyzed using PKMAS software (Protokinetics) and statistical analysis performed using SPSS 22 (IBM).

Results: 70 age-matched subjects (21 PD FOG, 26 PD no-FOG, and 23 HC) were enrolled. Disease duration was similar between PD FOG and no-FOG groups (8.9±5.6 vs. 7.5±6.5; p=0.43). Mean Giladi FOG-Q scores (11.4±3.6 vs. 2.6±2.9; p<0.001) and Hoehn & Yahr scores (2.2±0.6 vs. 1.7±0.5; p<0.005) were higher, and MoCA scores (25±3.3 vs. 26.5±2.8; p=0.11) were not significantly different in the PD FOG vs. no-FOG groups. Mean stride length and stride velocity were significantly lower in both PD no-FOG and FOG groups compared to HC while stance percent and total double support percent were significantly higher, but only stride length and stride velocity were statistically significant between PD FOG and no-FOG groups  (111.2±21.3 vs. 127.7±16.9 cm; p<0.01 and 104.0±19.2 vs. 114.8±15.2 cm; p=0.05 respectively). Percent coefficient of variation (%CV) was also significantly different between the PD FOG and no-FOG groups in stride length (5.1±1.6 vs. 3.7±1.2cm; p<0.005) and stride velocity (6.5±2.1 vs. 5.1±1.4 cm/s; p<0.05), but not total double support or stance percent.

Conclusions: PD patients with FOG had decreased stride length and stride velocity and increased variability in stride length and stride velocity, but not total double support or stance percent. This differential regulation suggests that objective gait assessment could provide a way to predict FOG in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/objective-gait-parameters-as-a-noninvasive-biomarker-for-freezing-of-gait-in-parkinsons-disease-patients/