Parkinson's and Gait

Are gait changes predictive of Parkinson’s disease?

-We have all seen people with this slowing, festination type gait in our practices. Parkinson’s disease or Parkinson spectrum is due to degeneration of a dopaminergic pathway in your brain stem called the nigiostriatal pathway between the substantia nigra and corpus striatum of the basil ganglia. You probably remember that the basil ganglia is responsible for coordination of movement and background positioning of joints to superimpose motion on top of.

-A recent paper talks about gait changes; observing 14 different parameters and guess what? 

- Gait changes pre-dated Parkinson’s onset by about 4 to 5 years. The largest changes were in gait asymmetry including step length and speed of motion.

-The real question becomes “are these changes inevitable or are they preventable with appropriate therapy?“ 

–we think so, largely because of the brains amazing abilities and neural plasticity. Rehab has a cognitive component that we feel is just as important as the exercise component.

#parkinsons #gait  #parkinsonsdisease #clinicalexam #predictivefactors 

Del Din S, Elshehabi M, Galna B, et al. Gait analysis with wearables predicts conversion to parkinson disease. Ann Neurol. 2019;86(3):357-367. doi:10.1002/ana.25548