The purpose of our study was to investigate gait dynamics and kinematics in patients with Parkinson’s disease (PD) and to correlate these features with the predominant clinical features and with the presence of the freezing of gait (FOG). We measured the temporospatial and kinematic parameters of gait in 30 patients with PD (M:F=12:18, age=68.43±7.54) using a computerized video motion analysis system.
We divided the subjects into subgroups: (1) tremor-dominant (TD) group and postural instability and gait disturbance (PIGD) group and (2) FOG group and non-FOG group. We compared the gait parameters between the subgroups.
The walking velocity and stride length were reduced significantly in the PIGD group compared to the TD group. The PIGD group showed a significantly reduced range of motion in the pelvic and lower extremity joints by kinematics. Stride time variability was significantly increased and the pelvic oblique range was significantly reduced in the freezing gait disorder group.
Our findings suggest that there are differences in the perturbation of the basal ganglia-cortical circuits based on major clinical features. The reduction of the pelvic oblique range of motion may be a compensatory mechanism for postural instability and contributes to stride time variability in patients with FOG.
Citations
Parkinson’s disease (PD) is characterized by motor and non-motor symptoms including cognitive, autonomic, sleep, and sensory disturbances. Cognitive impairment may occur in up to 80% of PD patients, and dementia in approximately 30%. The purpose of this study is to evaluate the frequency of cognitive impairment and the characteristics of cognitive deficits and to know the possibility of early detection of cognitive deficits in outpatient clinics with the questionnaire for patients and caregivers.
A total of 129 consecutive patients with idiopathic Parkinson’s disease were visited movement clinic from March 2006 to August 2006. Eighty-five patients performed cognitive test and questionnaires. All patients had motor symptoms with Hoehn and Yahr stage 0.5 to 3 (mean: 1.98±0.617), and evaluated with cognition by K-MMSE (Korean version of Mini-mental status examination), 7-MS (7-minutes screen test), and demographic features.
The frequency of cognitive impairment in PD patients was 44.7% (38/85), among them thirty (78.9%) patients complained memory disturbance. The characteristics of cognitive test were retrieval defect in memory, visuospatial dysfunction and categorical word fluency. With questionnaire, the complaint of memory decline and difficulties in activity of daily living (ADL) w ere important points of cognitive deficit in PD patients. However questionnaire did not showed significant correlation between complain of memory decline and cognitive deficit, only regular check with cognitive function test revealed the patient’s early cognitive impairment.
The cognitive impairment was frequent in PD patients. The characteristics of cognitive testing w ere retrieval defect in memory function and frontal executive dysfunction.