title: Disturbances of automatic gait control mechanisms in higher level gait disorder.
abstract: The underlying mechanisms responsible for the gait changes in frontal gait disorder (FGD), a form of higher level gait disorders, are poorly understood. We investigated the relationship between stride length and cadence (SLCrel) in people with FGD (n=15) in comparison to healthy older adults (n=21) to improve our understanding of the changes to gait in FGD. Gait data was captured using an electronic walkway system as participants walked at five self-selected speed conditions: preferred, very slow, slow, fast and very fast. Linear regression was used to determine the strength of the relationship (R(2)), slope and intercept. In the FGD group 9 participants had a strong SLCrel (linear group) (R(2)>0.8) and 6 a weak relationship (R(2)<0.8) (nonlinear group). The linear FGD group did not differ to healthy control for slope (p>0.05) but did have a lower intercept (p<0.001). The linear FGD group modulated gait speed by adjusting stride length and cadence similar to controls whereas the nonlinear FGD participants adjusted stride length but not cadence similar to controls. The non-linear FGD group had greater disturbance to their gait, poorer postural control and greater fear of falling compared to the linear FGD group. Investigation of the SLCrel resulted in new insights into the underlying mechanisms responsible for the gait changes found in FGD. The findings suggest stride length regulation was disrupted in milder FGD but as the disorder worsened, cadence control also became disordered resulting in a break down in the relationship between stride length and cadence.
authors.affiliation: Clinical Research Centre for Movement Disorders and Gait, The National Parkinson Foundation Center of Excellence, Kingston Centre, Monash Health, Cheltenham, Victoria 3192, Australia. Electronic address: Mary.Danoudis@monashhealth.org.
authors.forename: Mary
authors.initials: M
authors.lastname: Danoudis
authors.affiliation: Clinical Research Centre for Movement Disorders and Gait, The National Parkinson Foundation Center of Excellence, Kingston Centre, Monash Health, Cheltenham, Victoria 3192, Australia. Electronic address: ganga.ganesvaran@monashhealth.org.
authors.forename: Ganga
authors.initials: G
authors.lastname: Ganesvaran
authors.affiliation: Department of Medicine, Monash University, Clayton 3800, Australia. Electronic address: robert.iansek@monash.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Iansek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D008297:Male; D012720:Severity of Illness Index; D016138:Walking; D000072797:Walking Speed
keywords: Cadence; Frontal gait; Gait disorder; Linear regression; Neurologic; Stride length