Identifying the factors that contribute to gait efficacy in people with Parkinson's disease

Self-efficacy, or an individual's belief in their ability to complete tasks, plays a critical role in mobility. Reduced gait efficacy can lead older adults to limit their walking and physical activities, despite their abilities. Limited information exists on the factors that contribute to gait efficacy among patients with Parkinson's disease (PD).

To identify motor and non-motor factors that are associated with gait efficacy in people with PD.

Gait efficacy was evaluated using the modified Gait Efficacy Scale (mGES) in 57 people with PD (30 women; mean age: 68.4 ± 7.2 yrs; disease duration: 5 ± 2.8 yrs; MDS-UPDRS part III: 24.7 ± 13.6). Potential contributing factors included age, sex, disease duration and severity, the Falls Efficacy Scale-International (FES-I), the Activities-specific Balance Confidence Scale (ABC), the 6-Minute Walk Test (6MWT), the Timed Up and Go test, and the Short Physical Performance Battery (SPPB).

mGES was negatively correlated with disease duration, age, and FES-I and positively with ABC, SPPB, and 6MWT, but not with disease severity (p = 0.129). Regression analysis revealed a significant link between mGES and FES-I after adjusting for covariates (adjusted R²=0.687). FES-I was the strongest predictor (β=-0.731, p < 0.001). A model including 6MWT remained significant (p < 0.001, adjusted R²=0.708), with FES-I as the primary predictor (β=-0.653, p < 0.001). Stepwise regression identified ABC, FES-I, and age as significant predictors, explaining 81.5% of the variance in mGES.

Age, fear-of-falling, perceived balance, and mobility are related to gait efficacy in individuals with PD. Interventions to enhance gait efficacy in people with PD should address both psychological and physical factors.