Is reduced arm and leg swing in Parkinson's disease associated with rigidity or bradykinesia?
OBJECTIVE
Arm and leg swings during gait are reduced and asymmetric in Parkinson's disease (PD). Although rigidity and bradykinesia are interconnected with each other, and related with gait hypokinesia including arm and leg swing alteration, it remains uncertain which factor is more responsible for the decrease of arm and leg swings. The study aimed to uncover which factor between rigidity and bradykinesia is more associated with the reduction of arm and leg swings during gait.


METHODS
Patients with PD were selected and divided into a concordance group (21 patients) representing a match of both symptoms and a discordance group (nineteen patients) exhibiting a mismatch of pronounced rigidity and bradykinesia. Visual inspections of video clips for asymmetric features of gait and posture including arm swing, leg swing, shoulder position, external foot rotation were analyzed and accessed by two independent neurologists blindly.


RESULTS
The side of more pronounced rigidity was significantly and moderately related with the side of more decreased arm and leg swings (p<0.001, κ=0.592 in arm swing; p=0.011, κ=0.432 in leg swing, respectively), but the side of more dominant bradykinesia was associated with neither arm nor leg swing asymmetry (p=1, κ=0.014 in arm swing; p=1, κ=-0.036 in leg swing). In addition, asymmetric posturing including shoulder position and a laterally rotated foot showed no relationship with rigidity or bradykinesia.


CONCLUSIONS
The reduction of arm and leg swings during gait in PD was associated with rigidity, but not with bradykinesia.
Department of Neurology and Parkinson's Disease Centre, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Kyum-Yil
KY
Kwon
Department of Neurology and Parkinson's Disease Centre, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Minjik
M
Kim
Department of Neurology and Parkinson's Disease Centre, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Seon-Min
SM
Lee
Department of Neurology and Parkinson's Disease Centre, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Sung Hoon
SH
Kang
Department of Neurology and Parkinson's Disease Centre, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Hye Mi
HM
Lee
Department of Neurology and Parkinson's Disease Centre, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: parkinson@korea.ac.kr.
Seong-Beom
SB
Koh
D000161:Acoustic Stimulation / Q000009:adverse effects; D000368:Aged; D001132:Arm / Q000503:physiopathology*; D005260:Female; D020234:Gait Ataxia / Q000209:etiology*; D006801:Humans; D018476:Hypokinesia / Q000209:etiology*; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D009127:Muscle Rigidity / Q000209:etiology*; D010300:Parkinson Disease / Q000150:complications*; D011187:Posture / Q000502:physiology; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
Arm and leg swings; Bradykinesia; Parkinson's disease; Rigidity