Speed-dependent changes in shoulder-hip coordination and upper limb variability during gait in older adults with...

Coordination between upper and lower limbs is fundamental to human gait. Changes in this coordination are well described in Parkinson's disease (PD), but there is limited information on the upper limbs' continuous relative phase and coordination variability during walking in people with PD (PwPD), considering different phases of the gait cycle and varying walking speeds.

Do older adults with PD present altered upper limbs continuous relative phase (CRP) and coordination variability across the different subphases of gait cycle and walking speeds, compared to older adults without PD?

This cross-sectional observational study included 20 older adults with PD and 10 older adults without PD. Participants underwent gait kinematic analysis using a three-dimensional motion capture system on a treadmill at 0.28 and 0.83 m/s. The mean CRP and coordination variability in shoulder-elbow and shoulder-hip pairs were calculated. Statistical analysis employed the Generalized Estimating Equations method to compare groups and evaluate group*speed interactions.

Older adults with PD exhibit distinct upper limb-hip coordination strategies as walking speed increases, especially during the final subphases of the gait cycle, compared to those without PD. Older adults with and without PD decrease variability in upper limb coordination with rising speed, and shoulder-hip segments are only affected during the push-off phase.

These findings highlight the distinct motor coordination challenges faced by older adults with PD and underscore the importance of targeted interventions, focusing on improving shoulder-hip and arms coordination to improve gait dynamics in this population.