Gait parameters of Parkinson's disease compared with healthy controls: a systematic review and meta-analysis

Abstract

We systematically reviewed observational and clinical trials (baseline) studies examining differences in gait parameters between Parkinson's disease (PD) in on-medication state and healthy control. Four electronic databases were searched (November-2018 and updated in October-2020). Independent researchers identified studies that evaluated gait parameters measured quantitatively during self-selected walking speed. Risk of bias was assessed using an instrument proposed by Downs and Black (1998). Pooled effects were reported as standardized mean differences and 95% confidence intervals using a random-effects model. A total of 72 studies involving 3027 participants (1510 with PD and 1517 health control) met the inclusion criteria. The self-selected walking speed, stride length, swing time and hip excursion were reduced in people with PD compared with healthy control. Additionally, PD subjects presented higher cadence and double support time. Although with a smaller difference for treadmill, walking speed is reduced both on treadmill (.13 m s^-1) and on overground (.17 m s^-1) in PD. The self-select walking speed, stride length, cadence, double support, swing time and sagittal hip angle were altered in people with PD compared with healthy control. The precise determination of these modifications will be beneficial in determining which intervention elements are most critical in bringing about positive, clinically meaningful changes in individuals with PD (PROSPERO protocol CRD42018113042).

Figure 1

Flowchart of number of articles retrieved during the literature search and study selection.

Figure 2

Standardized mean differences on gait speed between Parkinson and healthy individuals. CI confidence interval, Std diff standardized difference.

Figure 3

Standardized mean differences on stride length between Parkinson and healthy individuals. CI confidence interval, Std diff standardized difference.

Figure 4

Standardized mean differences on gait cadence between Parkinson and healthy individuals. CI confidence interval, Std diff standardized difference.