Related Experiment Video
Updated: Dec 12, 2025
Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease
Published on: July 24, 2019
Day-to-Day Variability of Walking Performance Measures in Individuals Poststroke and Individuals With Parkinson
Carey L Holleran1, Marghuretta D Bland, Darcy S Reisman
1Program in Physical Therapy (C.L.H., M.D.B., G.M.E., C.E.L.), Program in Occupational Therapy (M.D.B., C.E.L.), Department of Neurology (C.L.H., M.D.B., G.M.E., C.E.L.), and Department of Neuroscience (G.M.E.), Washington University School of Medicine, St Louis, Missouri; Department of Physical Therapy, University of Delaware, Newark (D.S.R.); and Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent, Boston University, Boston, Massachusetts (T.D.E.).
Background And Purpose:
Improvement of walking performance is a primary goal for individuals poststroke or with Parkinson disease (PD) who receive physical therapy. More data about day-to-day variability of walking performance are critical for determining if changes in performance have occurred.
Methods:
Baseline assessments were utilized from an ongoing, observational, prospective cohort study including 84 individuals poststroke (n = 37) or with PD (n = 47) receiving outpatient physical therapy services to improve mobility. Participants wore step activity monitors for up to 7 days to measure walking performance (steps per day, walking duration, maximum 30-minute output, and peak activity index) in daily life. Correlation analyses evaluated relationships between both capacity and performance measures as well as the relationships between mean performance variables and day-to-day variability. Regression analyses explored factors that contribute to variability in day-to-day performance variables.
Results:
Mean steps per day for participants poststroke (5376 ± 2804) and with PD (8149 ± 4490) were consistent with previously reported cohorts. Greater amounts of walking were related to more day-to-day variability, with moderate correlations found between the mean and day-to-day variability of each performance measure, regardless of medical diagnosis or walking speed. Day-to-day variability is large (upwards of 50% of the mean), with the amount of walking performance serving as the primary predictor of day-to-day variability in walking performance.
Discussion And Conclusions:
The results of this study elucidate the factors that are related to and predict day-to-day variability of performance. Walking performance metrics should be evaluated over multiple days and greater variability should be anticipated with greater amounts of performance.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A319).
