Gait Patterns and Balance Impairment in Parkinson’s Disease With Correlation to Disease Severity
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Background and Purpose: Accurate and early diagnosis of Parkinson’s disease (PD) remains challenging, as clinical assessments have notable limitations. Gait impairment, a hallmark motor symptom, appears in the early stages and is indicative of disease evolution. This study aimed to examine gait parameters and their associations with established clinical measures to assess their potential as diagnostic and monitoring biomarkers in a Korean PD cohort. Methods: PD patients (n=18) and healthy controls (HCs, n=15) underwent gait assessments with MotionCore (JEIOS Inc.). Gait parameters were measured during both the 10-m walk (locomotion) and Timed Up and Go (TUG) tests, including stride length, cadence, single and double support time, toe-off time, and turning performance. Clinical assessments comprised the Hoehn & Yahr (H&Y) scale, Unified Parkinson’s Disease Rating Scale Part III, Freezing of Gait Questionnaire, Korean version of the Mini-Mental State Examination, Geriatric Depression Scale, and Berg Balance Scale. Results: Patients with PD demonstrated significantly shortened stride length and higher cadence. Reduced single support time, extended double support time, and delayed toe-off time were observed in the PD group. Integrating gait metrics from both the 10-m locomotion and TUG tests improved discrimination between PD patients and healthy controls, as well as among different H&Y stages. Turning-related measures were significantly higher in PD patients. Gait measures showed robust correlations with clinical indices, including motor severity, cognitive status, and balance scores. Conclusions: Gait analysis identified prominent motor and balance deficits in PD patients that were strongly associated with clinical severity. Gait parameters hold considerable potential as objective digital biomarkers for the diagnosis and monitoring of PD progression.
Abstract
Background and Purpose: Accurate and early diagnosis of Parkinson’s disease (PD) remains challenging, as clinical assessments have notable limitations. Gait impairment, a hallmark motor symptom, appears in the early stages and is indicative of disease evolution. This study aimed to examine gait parameters and their associations with established clinical measures to assess their potential as diagnostic and monitoring biomarkers in a Korean PD cohort. Methods: PD patients (n=18) and healthy controls (HCs, n=15) underwent gait assessments with MotionCore (JEIOS Inc.). Gait parameters were measured during both the 10-m walk (locomotion) and Timed Up and Go (TUG) tests, including stride length, cadence, single and double support time, toe-off time, and turning performance. Clinical assessments comprised the Hoehn & Yahr (H&Y) scale, Unified Parkinson’s Disease Rating Scale Part III, Freezing of Gait Questionnaire, Korean version of the Mini-Mental State Examination, Geriatric Depression Scale, and Berg Balance Scale. Results: Patients with PD demonstrated significantly shortened stride length and higher cadence. Reduced single support time, extended double support time, and delayed toe-off time were observed in the PD group. Integrating gait metrics from both the 10-m locomotion and TUG tests improved discrimination between PD patients and healthy controls, as well as among different H&Y stages. Turning-related measures were significantly higher in PD patients. Gait measures showed robust correlations with clinical indices, including motor severity, cognitive status, and balance scores. Conclusions: Gait analysis identified prominent motor and balance deficits in PD patients that were strongly associated with clinical severity. Gait parameters hold considerable potential as objective digital biomarkers for the diagnosis and monitoring of PD progression.