Contribution of Step Length to Increase Walking and Turning Speed as a Marker of Parkinson's Disease Progression.
When increasing ambulation speed in Parkinson's disease, step cadence increases more than stride length, indicating movement scaling difficulties that affect step generation in particular. We investigated whether step length variation when increasing ambulation speed was related to disease progression. Patients with Parkinson's disease (N = 39) and controls (N = 152) performed two timed ambulation tasks: at a 'free' (self-selected) pace and then at 'maximal' speed. The total number of steps (including during turns) and time to complete the task were clinically measured. The relative contribution of step length and cadence to increased ambulation speed was determined using two methods: the ratios of change in step length or in cadence to the change in ambulation speed, and the step length index. While the relative contribution of step length and cadence to increased ambulation speed was independent of age in both control and patient groups, in Parkinson's disease there was a negative correlation between time from diagnosis and the ratio of change in step length to change in ambulation speed (R = 0.54; p = 0.0004) and the step length index (R = 0.56, p = 0.0002). In parallel, there was a positive correlation between time since diagnosis and the ratio of change in cadence to change in ambulation speed (R = 0.57; p = 0.0002). The relative contribution of step length and cadence to increased ambulation speed is age invariant but a marker of Parkinson's disease advancement, and can be easily determined in the clinical setting.
Laboratoire Analyse et Restauration du Mouvement, EA BIOTN 7377, Hôpitaux Universitaires Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France.
Nicolas
N
Bayle
Robert and John M. Bendheim Parkinson and Movement Disorders Center, Department of Neurology, Mount Sinai School of Medicine, New York, United States of America.
Amar S
AS
Patel
Neurosurgery Department, Mount Sinai School of Medicine, New York, NY, United States of America.
Diana
D
Crisan
Neurosurgery Department, Mount Sinai School of Medicine, New York, NY, United States of America.
Lanjun J
LJ
Guo
Laboratoire Analyse et Restauration du Mouvement, EA BIOTN 7377, Hôpitaux Universitaires Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France.
Emilie
E
Hutin
Neurosurgery Department, Mount Sinai School of Medicine, New York, NY, United States of America.
Donald J
DJ
Weisz
Robert and John M. Bendheim Parkinson and Movement Disorders Center, Department of Neurology, Mount Sinai School of Medicine, New York, United States of America.|Human Aerospace Laboratory, Department of Neurology, Mount Sinai School of Medicine, New York, United States of America.
Steven T
ST
Moore
Robert and John M. Bendheim Parkinson and Movement Disorders Center, Department of Neurology, Mount Sinai School of Medicine, New York, United States of America.
Jean-Michel
JM
Gracies
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology / Q000503:physiopathology*; D012189:Retrospective Studies; D016138:Walking