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Adjustability of Gait Speed in Clinics and Free-Living Environments for People With Parkinson’s Disease
Yuki Nishi, Shintaro Fujii, Koki Ikuno, Yuta Terasawa, Shu Morioka
J Mov Disord. 2024;17(4):416-424.   Published online September 23, 2024
DOI: https://doi.org/10.14802/jmd.24167
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  • 6 Crossref
AbstractAbstract PDF
Objective
Gait speed is regulated by varying gait parameters depending on the diverse contexts of the environment. People with Parkinson’s disease (PwPD) have difficulty adapting to gait control in their environment; however, the relationships between gait speed and spatiotemporal parameters in free-living environments have not been clarified. This study aimed to compare gait parameters according to gait speed in clinics and free-living environments.
Methods
PwPD were assessed at the clinic and in a free-living environment using an accelerometer on the lower back. By fitting a bimodal Gaussian model to the gait speed distribution, gait speed was divided into lower and higher speeds. We compared the spatiotemporal gait parameters using a 2 × 2 (environment [clinic/free-living] × speed [lower/higher]) repeated-measures analysis of variance. Associations between Parkinson’s disease symptoms and gait parameters were evaluated using Bayesian Pearson’s correlation coefficients.
Results
In the 41 PwPD included in this study, spatiotemporal gait parameters were significantly worse in free-living environments than in clinics and at lower speeds than at higher speeds. The fit of the walking speed distribution to the bimodal Gaussian model (adjustability of gait speed) in free-living environments was related to spatiotemporal gait parameters, severity of Parkinson’s disease, number of falls, and quality of life.
Conclusion
The findings suggest that gait control, which involves adjusting gait speed according to context, differs between clinics and free-living environments in PwPD. Gait assessments for PwPD in both clinical and free-living environments should interpret gait impairments in a complementary manner.

Citations

Citations to this article as recorded by  
  • Risk of Falls and Need of Walking Aid in Parkinson's Disease: Incidence and Impact of Comorbidities
    Louise‐Laure Mariani, Benjamin Dano, Marion Houot, Graziella Mangone, Fernando Pico, Olivier Rascol, Ana Marques, Pascal Derkinderen, Marie Vidailhet, Alexis Brice, Jean‐Christophe Corvol
    Movement Disorders Clinical Practice.2026;[Epub]     CrossRef
  • Multimodal machine learning mobility assessment in Parkinson’s disease within supervised and unsupervised settings
    Y. Celik, H. Kuduz, F. V. Engin, F. Kacar, E. Tarakci, L. T. Pearson-Noseworthy, J. Das, S. Stuart, W. L. Woo, A. Godfrey
    Journal of NeuroEngineering and Rehabilitation.2026;[Epub]     CrossRef
  • Gait Instability and Compensatory Mechanisms in Parkinson’s Disease Patients With Camptocormia: An Exploratory Study
    Hideyuki Urakami, Yasutaka Nikaido, Yuta Okuda, Yutaka Kikuchi, Ryuichi Saura, Yohei Okada
    Journal of Movement Disorders.2025; 18(2): 127.     CrossRef
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    Journal of the American Medical Directors Association.2025; 26(9): 105764.     CrossRef
  • A systematic review of real-world gait-related digital mobility outcomes in Parkinson’s disease
    Cameron Kirk, Emma Packer, Ashley Polhemus, Mhairi K. MacLean, Harry Bailey, Felix Kluge, Heiko Gaßner, Lynn Rochester, Silvia Del Din, Alison J. Yarnall
    npj Digital Medicine.2025;[Epub]     CrossRef
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    BMC Musculoskeletal Disorders.2025;[Epub]     CrossRef

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