Forward and backward walking in Parkinson disease: A factor analysis

Area of Science:

• Neuroscience
• Biomechanical analysis
• Movement disorders

Background:

• Parkinson disease (PD) impairs both forward and backward walking.
• Understanding the relationship between these gait patterns is crucial for effective clinical assessment.

Purpose of the Study:

• To investigate the underlying gait factors in forward and backward walking in individuals with PD.
• To determine the additive value of assessing backward walking in a clinical setting, considering levodopa response differences.

Main Methods:

• Exploratory factor analysis was applied to gait data from 62 PD patients and 11 controls.
• Participants performed forward and backward walking tasks on an instrumented walkway, both OFF and ON levodopa medication.

Main Results:

• Four common gait factors (Variability, Rhythm, Asymmetry, Pace) were identified for both forward and backward walking, in both OFF and ON levodopa states.
• A fifth factor, Posture, emerged in the ON levodopa state for backward walking.
• Levodopa response was notably reduced in backward walking compared to forward walking.

Conclusions:

• Gait domains are similar across forward and backward walking in PD.
• Backward walking may be more complex, leading to a diminished levodopa response.
• The study provides a valuable normative dataset for evaluating forward and backward walking in PD patients.