Chaewon Shin1, Tae-Beom Ahn2. 1. Department of Neurology, Chungnam National University Hospital, College of Medicine, Chungnam National University, Daejeon, Republic of Korea. 2. Department of Neurology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea. Electronic address: taebeom.ahn@khu.ac.kr.
Abstract
BACKGROUND: Gait disturbance gradually worsens as Parkinson's disease (PD) progresses, which significantly affects the quality of life of PD patients. Treadmill-based gait analysis systems can measure gait parameters including the dynamic center-of-pressure (COP) trajectory during ambulation. In this study, we hypothesized that altered dynamic COP changes are new gait characteristics for PD patients. METHODS: Dynamic COP parameters and classic spatiotemporal parameters were obtained for each patient using a treadmill-based system at the maximal comfortable treadmill speed (MCTS). We compared dynamic COP parameters between 44 PD patients and 31 controls, correlated these parameters with clinical and spatiotemporal data, and adjusted for age and MCTS to determine whether the parameters were independent from the treadmill speed. We also evaluated characteristics of COP parameters in relation to the more and less affected sides in PD patients. RESULTS: During treadmill walking the length of the COP trajectory in the stance phase was decreased, an effect that was more prominent on the more affected side in PD patients. COP parameters related to this change were significantly altered in patients when compared to controls. Asymmetry of the COP trajectories compared between both feet was identified as a significant gait characteristic after adjusting for age and MCTS. The overlaid graphical display of dynamic COP trajectory in PD patients showed "distorted butterfly with asymmetric wing" feature. CONCLUSION: Dynamic COP asymmetry provides a new and intuitive way to analyze gait abnormalities of PD patients. Further studies with prospective designs will substantiate the clinical usefulness of this feature of gait.
BACKGROUND: Gait disturbance gradually worsens as Parkinson's disease (PD) progresses, which significantly affects the quality of life of PDpatients. Treadmill-based gait analysis systems can measure gait parameters including the dynamic center-of-pressure (COP) trajectory during ambulation. In this study, we hypothesized that altered dynamic COP changes are new gait characteristics for PDpatients. METHODS: Dynamic COP parameters and classic spatiotemporal parameters were obtained for each patient using a treadmill-based system at the maximal comfortable treadmill speed (MCTS). We compared dynamic COP parameters between 44 PDpatients and 31 controls, correlated these parameters with clinical and spatiotemporal data, and adjusted for age and MCTS to determine whether the parameters were independent from the treadmill speed. We also evaluated characteristics of COP parameters in relation to the more and less affected sides in PDpatients. RESULTS: During treadmill walking the length of the COP trajectory in the stance phase was decreased, an effect that was more prominent on the more affected side in PDpatients. COP parameters related to this change were significantly altered in patients when compared to controls. Asymmetry of the COP trajectories compared between both feet was identified as a significant gait characteristic after adjusting for age and MCTS. The overlaid graphical display of dynamic COP trajectory in PDpatients showed "distorted butterfly with asymmetric wing" feature. CONCLUSION: Dynamic COP asymmetry provides a new and intuitive way to analyze gait abnormalities of PDpatients. Further studies with prospective designs will substantiate the clinical usefulness of this feature of gait.
Authors: Sara Mollà-Casanova; Jose Pedrero-Sánchez; Marta Inglés; Juan López-Pascual; Elena Muñoz-Gómez; Marta Aguilar-Rodríguez; Nuria Sempere-Rubio; Pilar Serra-Añó Journal: Front Aging Neurosci Date: 2022-06-15 Impact factor: 5.702