Prescribed Gait Tests Versus Continuous Monitoring of Gait in People With Parkinson’s Disease
Objective: To determine if prescribed self-administered gait tests are a valid measure of functional everyday mobility in people with idiopathic Parkinson’s disease (PD).
Background: Motor fluctuations are a frequent complication of the long-term use of antiParkinsonian medication. Yet, the assessment of gait in the clinic at a singular moment may not adequately reflect functional everyday mobility. In this study we investigate quality of mobility in people with Parkinson’s disease over a week of continuous monitoring in the home and how it relates to self-administered gait tests in the home.
Methods: We recruited 20 people with PD (Hoehn and Yahr stage 2) and 10 age-matched healthy control subjects. Subjects wore three inertial sensors (Opals, APDM) attached to both feet and the lumbar region for a week of continuous monitoring. Each day subjects performed prescribed 2-min walking tests in the morning, before their levodopa medication intake (‘Prescribed – OFF’) and one hour after intake of the first dose of the day (‘Prescribed – ON’). Gait was detected as walking bouts of at least 4 steps.
Results: Preliminary analyses of continuous monitoring of gait of a full-day and prescribed 2-min walking tests of a person with PD and a healthy control subject are given in Figure 1. In the person with PD, gait speed and stride length improved after levodopa intake (Prescribed – OFF vs ON). It appears that during continuous monitoring gait speed, stride length and double support was more variable than during prescribed gait test. The control subject showed high consistency between the two prescribed gait tests. Gait during continuous monitoring was again more variable and slower.
Conclusions: Prescribed gait tests accurately capture mobility at a singular moment. Continuous measures of gait might be more accurate to capture motor fluctuations due to medication intake in functional everyday mobility in people with PD.
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C. Curtze, J. McNames, M. El-Gohary, J.G. Nutt, M. Mancini, P. Carlson-Kuhta, F.B. Horak. Prescribed gait tests versus continuous monitoring of gait in people with Parkinson’s disease. Mov Disord. 2016; 31 (suppl 2).