Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease

BackgroundGait parameters are considered potential diagnostic markers of Parkinson's disease (PD). We aimed to 1) assess the gait impairment in early-stage PD and its related factors in the single-task (ST) and dual-task (DT) walking tests and 2) evaluate and compare the diagnostic value of gai...

Full description

Bibliographic Details
Main Authors: Xiaodan Zhang, Weinv Fan, Hu Yu, Li Li, Zhaoying Chen, Qiongfeng Guan
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-10-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2022.974985/full
_version_ 1797594827022401536
author Xiaodan Zhang
Weinv Fan
Hu Yu
Li Li
Zhaoying Chen
Qiongfeng Guan
author_facet Xiaodan Zhang
Weinv Fan
Hu Yu
Li Li
Zhaoying Chen
Qiongfeng Guan
author_sort Xiaodan Zhang
collection DOAJ
description BackgroundGait parameters are considered potential diagnostic markers of Parkinson's disease (PD). We aimed to 1) assess the gait impairment in early-stage PD and its related factors in the single-task (ST) and dual-task (DT) walking tests and 2) evaluate and compare the diagnostic value of gait parameters for early-stage PD under ST and DT conditions.MethodsA total of 97 early-stage PD patients and 41 healthy controls (HC) were enrolled at Hwa Mei hospital. Gait parameters were gathered and compared between the two groups in the ST and DT walking test, controlling for covariates. Utilizing the receiver operating characteristic curve, diagnostic parameters were investigated.ResultsIn the ST walking test, significantly altered gait patterns could be observed in early-stage PD patients in all domains of gait, except for asymmetry (P < 0.05). Compared to the ST walking test, the early-stage PD group performed poorly in the DT walking test in the pace, rhythm, variability and postural control domain (P < 0.05). Older, heavier subjects, as well as those with lower height, lower level of education and lower gait velocity, were found to have a poorer gait performance (P < 0.05). Stride length (AUC = 0.823, sensitivity, 68.0%; specificity, 85.4%; P < 0.001) and heel strike angle (AUC = 0.796, sensitivity, 71.1%; specificity, 80.5%; P < 0.001) could distinguish early-stage PD patients from HCs with moderate accuracy, independent of covariates. The diagnostic accuracy of gait parameters under ST conditions were statistically noninferior to those under DT conditions(P>0.05). Combining all gait parameters with diagnostic values under ST and DT walking test, the predictive power significantly increased with an AUC of 0.924 (sensitivity, 85.4%; specificity, 92.7%; P < 0.001).ConclusionGait patterns altered in patients with early-stage PD but the gait symmetry remained preserved. Stride length and heel strike angle were the two most prominent gait parameters of altered gait in early-stage of PD that could serve as diagnostic markers of early-stage PD. Our findings are helpful to understand the gait pattern of early-stage PD and its related factors and can be conducive to the development of new diagnostic tools for early-stage PD.
first_indexed 2024-03-11T02:29:11Z
format Article
id doaj.art-d66197207f9a40bc9adaf949bb096d5f
institution Directory Open Access Journal
issn 1664-2295
language English
last_indexed 2024-03-11T02:29:11Z
publishDate 2022-10-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Neurology
spelling doaj.art-d66197207f9a40bc9adaf949bb096d5f2023-11-18T10:24:44ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-10-011310.3389/fneur.2022.974985974985Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's diseaseXiaodan ZhangWeinv FanHu YuLi LiZhaoying ChenQiongfeng GuanBackgroundGait parameters are considered potential diagnostic markers of Parkinson's disease (PD). We aimed to 1) assess the gait impairment in early-stage PD and its related factors in the single-task (ST) and dual-task (DT) walking tests and 2) evaluate and compare the diagnostic value of gait parameters for early-stage PD under ST and DT conditions.MethodsA total of 97 early-stage PD patients and 41 healthy controls (HC) were enrolled at Hwa Mei hospital. Gait parameters were gathered and compared between the two groups in the ST and DT walking test, controlling for covariates. Utilizing the receiver operating characteristic curve, diagnostic parameters were investigated.ResultsIn the ST walking test, significantly altered gait patterns could be observed in early-stage PD patients in all domains of gait, except for asymmetry (P < 0.05). Compared to the ST walking test, the early-stage PD group performed poorly in the DT walking test in the pace, rhythm, variability and postural control domain (P < 0.05). Older, heavier subjects, as well as those with lower height, lower level of education and lower gait velocity, were found to have a poorer gait performance (P < 0.05). Stride length (AUC = 0.823, sensitivity, 68.0%; specificity, 85.4%; P < 0.001) and heel strike angle (AUC = 0.796, sensitivity, 71.1%; specificity, 80.5%; P < 0.001) could distinguish early-stage PD patients from HCs with moderate accuracy, independent of covariates. The diagnostic accuracy of gait parameters under ST conditions were statistically noninferior to those under DT conditions(P>0.05). Combining all gait parameters with diagnostic values under ST and DT walking test, the predictive power significantly increased with an AUC of 0.924 (sensitivity, 85.4%; specificity, 92.7%; P < 0.001).ConclusionGait patterns altered in patients with early-stage PD but the gait symmetry remained preserved. Stride length and heel strike angle were the two most prominent gait parameters of altered gait in early-stage of PD that could serve as diagnostic markers of early-stage PD. Our findings are helpful to understand the gait pattern of early-stage PD and its related factors and can be conducive to the development of new diagnostic tools for early-stage PD.https://www.frontiersin.org/articles/10.3389/fneur.2022.974985/fullgait analysisdual taskwearable sensorsParkinson's diseasediagnosis
spellingShingle Xiaodan Zhang
Weinv Fan
Hu Yu
Li Li
Zhaoying Chen
Qiongfeng Guan
Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease
Frontiers in Neurology
gait analysis
dual task
wearable sensors
Parkinson's disease
diagnosis
title Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease
title_full Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease
title_fullStr Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease
title_full_unstemmed Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease
title_short Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease
title_sort single and dual task gait performance and their diagnostic value in early stage parkinson s disease
topic gait analysis
dual task
wearable sensors
Parkinson's disease
diagnosis
url https://www.frontiersin.org/articles/10.3389/fneur.2022.974985/full
work_keys_str_mv AT xiaodanzhang singleanddualtaskgaitperformanceandtheirdiagnosticvalueinearlystageparkinsonsdisease
AT weinvfan singleanddualtaskgaitperformanceandtheirdiagnosticvalueinearlystageparkinsonsdisease
AT huyu singleanddualtaskgaitperformanceandtheirdiagnosticvalueinearlystageparkinsonsdisease
AT lili singleanddualtaskgaitperformanceandtheirdiagnosticvalueinearlystageparkinsonsdisease
AT zhaoyingchen singleanddualtaskgaitperformanceandtheirdiagnosticvalueinearlystageparkinsonsdisease
AT qiongfengguan singleanddualtaskgaitperformanceandtheirdiagnosticvalueinearlystageparkinsonsdisease