Backward Gait is Associated with Motor Symptoms and Fear of Falling in Patients with Parkinson's Disease.

BACKGROUND AND PURPOSE

Many previous studies have investigated forward gait (FG), backward gait (BG), and dual-task gait (DG) in patients with Parkinson's disease (PD). However, it remains uncertain whether gait parameters are implicated in motor symptoms or the risk of falling, especially in patients with PD.

METHODS

Demographic and clinical characteristics including the Fear of Falling Measure (FFM) were assessed in patients with PD and in healthy subjects. A computerized gait analysis using the GAITRite system was performed for FG, BG, and DG. The Unified Parkinson's Disease Rating Scale Part III was assessed in patients with PD.

RESULTS

This prospective study included 24 patients with PD and 27 controls. Compared with controls, patients with PD showed a slower gait and shorter stride in all three gaits. Patients with PD also exhibited increases in the stride-to-stride variability in the stride time and stride length of the gait for BG, increased length for DG, and no increase for FG. Moreover, the BG speed in PD patients was significantly associated with their motor symptoms (bradykinesia, postural instability, gait difficulty, and total motor score) and negatively correlated with the FFM score.

CONCLUSIONS

The BG dynamics were more impaired and more closely related to motor symptoms and fear of falling than were the FG or DG dynamics in patients with PD, indicating that BG parameters are potential biomarkers for the progression of PD.