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Maximum Step Length Test Performance in People With Parkinson Disease: A Cross-sectional Study
Ryan P Duncan1, Marie E McNeely, Gammon M Earhart
1Program in Physical Therapy, Washington University School of Medicine in Saint Louis, Missouri (R.P.D., M.E.M., G.M.E.); Department of Neurology, Washington University School of Medicine in Saint Louis, Missouri (R.P.D., M.E.M., G.M.E.); and Department of Neuroscience, Washington University School of Medicine in Saint Louis, Missouri (G.M.E.).
The Maximum Step Length Test (MSLT) in Parkinson disease (PD) showed participants stepped furthest forward. While medication improved MSLT performance, its clinical significance for balance and gait hypokinesia requires further study.
Area of Science:
- Neurology
- Movement Disorders
- Biomedical Engineering
Background:
- The Maximum Step Length Test (MSLT) assesses large step production capacity.
- MSLT has been studied in older adults but not previously in Parkinson disease (PD).
- Characterizing MSLT performance and validity in PD is crucial for understanding gait impairments.
Purpose of the Study:
- To characterize the performance of the MSLT in individuals with idiopathic Parkinson disease (PD).
- To investigate the construct validity of the MSLT by correlating it with established motor performance measures in PD.
- To examine the influence of anti-Parkinson medication status on MSLT performance.
Main Methods:
- Forty participants with idiopathic PD completed the MSLT in both 'OFF' and 'ON' anti-PD medication states.
- Construct validity was assessed by correlating MSLT with Mini-BESTest, ABC scale, gait velocity, 6MWT, MDS-UPDRS III, and TUG.
- Repeated-measures ANOVA and Pearson/Spearman correlations were used to analyze medication effects, stepping direction, and construct validity.
Main Results:
- Participants consistently stepped further in the forward direction compared to backward and lateral directions, irrespective of medication status (P < 0.001).
- MSLT performance was significantly higher when participants were 'ON' medication versus 'OFF' medication (P = 0.004).
- MSLT demonstrated moderate to strong correlations with the Mini-BESTest, TUG, and 6MWT, indicating construct validity.
Conclusions:
- In people with PD, the MSLT reveals a directional preference for forward stepping.
- While medication improved MSLT performance, the increase may not be clinically significant.
- MSLT appears associated with balance and gait hypokinesia in PD, supported by its correlations with key motor assessments.
