Gait parameters contributing to freezing of gait in Parkinson's

Abstract

Freezing of gait (FOG) has been identified as one of the most severe gait impairments associated with Parkinson's disease (PD). While the pathophysiology remains poorly understood, research has debated whether spatial or temporal parameters might be at the root of FOG. Some research has argued that reduced stride length and increased stride length variability leads to FOG episodes, while others have pointed to a timing error linked to stride time variability. Thus, this study aimed to investigate which gait parameters contributed more to FOG. To do this, 139 participants with idiopathic PD were divided into two groups (PD+FOG, n=23) and (PD+non-FOG, n=116). Next, the stride length, stride time and the variability of these parameters were analyzed using gait data. All gait tasks involved 3 trials of walking in a straight line on a sensor carpet, and data was standardized across 4 software (PKMAS, Gaitrite, APDM and Optotrack). Independent t-tests indicated that there was a significant difference in stride length (t(445)= 4.401, p<0.000) and stride time variability (t(445)= -2.460, p=0.014) between both groups. Where, those in the PD+non-FOG group had a larger stride length (MD=12.71, SE=2.89) but those in the PD+FOG group experienced great stride time variability (MD= -0.035, SE=0.014). Interestingly, there was no difference in stride length variability and stride time between both groups. These findings will be discussed in terms of the distinct underlying mechanisms which contribute to FOG, with the overall goal of creating rehabilitative therapies that target these specific gait parameters to treat or even prevent FOG.