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. 2010 Feb;31(2):256-60.
doi: 10.1016/j.gaitpost.2009.10.013. Epub 2009 Nov 27.

Arm swing magnitude and asymmetry during gait in the early stages of Parkinson's disease

Michael D Lewek  1 , Roxanne Poole, Julia Johnson, Omar Halawa, Xuemei Huang
Affiliations

Arm swing magnitude and asymmetry during gait in the early stages of Parkinson's disease

Michael D Lewek et al. Gait Posture. 2010 Feb.

Abstract

The later stages of Parkinson's disease (PD) are characterized by altered gait patterns. Although decreased arm swing during gait is the most frequently reported motor dysfunction in individuals with PD, quantitative descriptions of gait in early PD have largely ignored upper extremity movements. This study was designed to perform a quantitative analysis of arm swing magnitude and asymmetry that might be useful in the assessment of early PD. Twelve individuals with early PD (in "off" state) and eight controls underwent gait analysis using an optically-based motion capture system. Participants were instructed to walk at normal and fast velocities, and then on heels (to minimize push-off). Arm swing was measured as the excursion of the wrist with respect to the pelvis. Arm swing magnitude for each arm, and inter-arm asymmetry, were compared between groups. Both groups had comparable gait velocities (p = 0.61), and there was no significant difference between the groups in the magnitude of arm swing in all walking conditions for the arm that swung more (p = 0.907) or less (p = 0.080). Strikingly, the PD group showed significantly greater arm swing asymmetry (asymmetry angle: 13.9 + or - 7.9%) compared to the control group (asymmetry angle: 5.1 + or - 4.0%; p = 0.003). Unlike arm swing magnitude, arm swing asymmetry unequivocally differs between people with early PD and controls. Such quantitative evaluation of arm swing, especially its asymmetry, may have utility for early and differential diagnosis, and for tracking disease progression in patients with later PD.

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Figures

Figure 1
Figure 1
Representative example of arm swing for an individual from PD group for an entire stride during (A) Normal, (B) Fast, and (C) Heel-Walking conditions. Arm swing magnitude was calculated as the total distance that the wrist travelled during an entire stride (e.g., path depicted by thick black lines), with respect to the origin of the pelvis (shown at 0,0 in the figures).
Figure 2
Figure 2
Arm swing asymmetry for the Normal, Fast, and Heel-Walking conditions is shown for the PD (white bars) and control (black bars) groups. Values represent mean and standard deviations. *: p<0.001, †: p<0.05
See this image and copyright information in PMC

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