Objective: ​To elucidate the characteristic of gait in patients with progressive supranuclear palsy (PSP) and compare to healthy elderly and patients with Parkinson’s disease (PD)

Background: Gait disturbance is one of main symptoms in PSP. PSP is a rare disease and their characteristic of gait has not been well understood. Therefore, the optimal physical therapy approach has not been established for their gait dysturbance in PSP.

Methods: Subjects were PSP (n = 24, 72.9 ± 6 y/o, man/female = 18/6), PD（n = 32, 71.1 ± 9 y/o, man/female = 18/14) and neurologically healthy elderly (CON, n = 29, 71.6 ± 6 y/o, man/female = 12/17) whose modified Rankin scale (mRS) were 4 or less. Gait patterns analysis was performed by using Walk Way MW-1000 (anima inc., Tokyo) and walking speed, cadence, stride length, step width, foot angle, walking cycle time and coefficient of variation (CV) of each parameter were measured. In the statistics, one-way ANOVA with post hoc Scheffe test was performed to compare all groups. For group differences were assessed using t-test and Mann-Whiteney U test. SPSS ver.23 statistical software was used to analyze the data and the criterion for significance was set at p < 0.05.

Results: There were no differences in the disease duration (PSP: 64.4 ± 53 mos., PD: 68.8 ± 56 mos.) and mRS (PSP: 3 [2.25-4], PD: [2-3]) between PSP and PD. The walking speed was lower and stride length was shorter significantly in PSP and PD than that of CON (p<0.05), but there was no difference between PSP and PD. The step width and foot angle were larger significantly in PSP than that of CON (p<0.05), but there was no difference between PD and CON. In addition, CV of walking cycle time was larger in PSP than that of CON and PD (p<0.05).

Conclusions: In PSP and PD, their walking abilities were markedly disturbed compared to CON. Furthermore, their step width, foot angle and variation of walking cycle time were significantly larger in PSP than PD. It has been reported that dentate nucleus, cerebellar white matter, potine nucleus, and inferior olivary nucleus were pathologically involved unlike PD. Therefore, the gait of PSP might be highly unstable by dysfunction of the cerebellum. As the result, they might increase in step width and foot angle as compensation to stable at their walking.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-characteristic-of-gait-in-progressive-progressive-supranuclear-palsy/