Objective: To determine if gait is affected in patients with essential tremor compared to healthy controls using quantitative gait assessment.

Background: Although essential tremor (ET) is primarily a tremor disorder, there is growing evidence that gait and balance difficulties can occur with ET. With the use of wireless sensors, quantitative gait assessment can be performed in clinic settings to reveal gait abnormalities which may be missed during clinical assessment. Gait measures can be utilized to monitor clinical progression and may potentially serve as a diagnostic tool along with clinical exam to differentiate ET with tremor predominant Parkinson disease (PD).

Method: Patients with a diagnosis of ET underwent gait and balance analyses during a routine clinic visit. Gait assessment was performed using Mobility labs (APDM Inc, Portland, OR) which consists of six wireless sensors on the ankles wrists, lumbar area and sternum. Each patient underwent the instrumented Stand and Walk (iSAW) test and data obtained was analyzed and compared with normative values.

Results: A total of 53 patients (M= 30, F = 23) underwent gait analysis. The mean age of patients with ET was 67.1 ± 9.9 years and mean duration of disease was 12.7±12.8 years. The duration for completing gait assessment in the clinic was between 3 to 10 minutes. In the iSAW test, ET patients were found to have reduced stride length, lower cadence, reduced gait speed and increased double support percent during the gait cycle compared to normative values. In the upper limbs, arm swing velocity and range of motion was also reduced bilaterally.  Additionally, there was increase in postural sway area and velocity.

Conclusion: Gait assessment using wireless sensors can be quickly and easily done in a clinic setting. In this study, patients with ET demonstrated impairment in multiple gait parameters compared to healthy controls.  Future studies are needed to determine if changes in gait parameters can be used to differentiate between ET and tremor predominant PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/quantitative-gait-assessment-of-patients-with-essential-tremor-using-wireless-sensors/