Mild Gait Impairment and Its Potential Diagnostic Value in Patients with Early-Stage Parkinson's Disease

Abstract

Background and Purpose. Patients with early-stage Parkinson's disease (PD) have gait impairments, and gait parameters may act as diagnostic biomarkers. We aimed to (1) comprehensively quantify gait impairments in early-stage PD and (2) evaluate the diagnostic value of gait parameters for early-stage PD. Methods. 32 patients with early-stage PD and 30 healthy control subjects (HC) were enrolled. All participants completed the instrumented stand and walk test, and gait data was collected using wearable sensors. Results. We observed increased variability of stride length (SL) (P<0.001), stance phase time (StPT) (P=0.004), and swing phase time (SwPT) (P=0.011) in PD. There were decreased heel strike (HS) (P=0.001), range of motion of knee (P=0.036), and hip joints (P<0.001) in PD. In symmetry analysis, no difference was found in any of the assessed gait parameters between HC and PD. Only total steps (AUC=0.763, P<0.001), SL (AUC=0.701, P=0.007), SL variability (AUC=0.769, P<0.001), StPT variability (AUC=0.712, P=0.004), and SwPT variability (AUC=0.688, P=0.011) had potential diagnostic value. When these five gait parameters were combined, the predictive power was found to increase, with the highest AUC of 0.802 (P<0.001). Conclusions. Patients with early-stage PD presented increased variability but still symmetrical gait pattern. Some specific gait parameters can be applied to diagnose early-stage PD which may increase diagnosis accuracy. Our findings are helpful to improve patient's quality of life.