Gait Analysis in Patients With Parkinson's Disease Off Dopaminergic Therapy

Objective: To compare time-distance, kinematic, and kinetic gait parameters in patients with idiopathic Parkinson's disease (PD) off dopaminergic therapy with a group of healthy control subjects. Design: A group-comparison study. Setting: Gait analysis laboratory. Participants: Patients with PD (n=20) and healthy age-matched controls (n=20). Interventions: Not applicable. Main Outcome Measures: Time-distance, kinematic, and kinetic gait variables. Results: PD patients walked slower with shorter stride-length, comparable cadence, and longer double support times. Kinematics showed a reduction of the range of motion in the hip, knee, and ankle joints. Maximum hip extension and the ankle plantar flexion were significantly reduced. Kinetic gait parameters showed reduced push-off ankle power and lift-off hip power generation. Strong correlations between these important body advancement mechanisms and the walking velocity were observed. Conclusions: In addition to previously described dysfunctional kinematics, abnormal kinetic parameters play an important role in the characterization of gait in PD patients off therapy. Hence, these parameters could be used to document treatment effects of parkinsonian gait disorders.