Effect of Levodopa and Environmental Setting on Gait and Turning Digital Markers Related to Falls in People with Parkinson's Disease

Vrutangkumar V. Shah, James McNames, Patricia Carlson-Kuhta, John G. Nutt, Mahmoud El-Gohary, Kristen Sowalsky, Martina Mancini, Fay B. Horak

Research output: Contribution to journalArticlepeer-review

Abstract

Background: It is unknown whether medication status (off and on levodopa) or laboratory versus home settings plays a role in discriminating fallers and non-fallers in people with Parkinson's disease (PD). Objectives: To investigate which specific digital gait and turning measures, obtained with body-worn sensors, best discriminated fallers from non-fallers with PD in the clinic and during daily life. Methods: We recruited 34 subjects with PD (17 fallers and 17 non-fallers based on the past 6 month's falls). Subjects wore three inertial sensors attached to both feet and the lumbar region in the laboratory for a 3-minute walking task (both off and on levodopa) and during daily life activities for a week. We derived 24 digital (18 gait and 6 turn) measures from the 3-minute walk and from daily life. Results: In clinic, none of the gait and turning measures collected during on levodopa state were significantly different between fallers and non-fallers. In contrast, digital measures collected in the off levodopa state were significantly different between groups, (average turn velocity, average number of steps to complete a turn, and variability of gait speed, P < 0.03). During daily life, the variability of average turn velocity (P = 0.023) was significantly different in fallers than non-fallers. Last, the average number of steps to complete a turn was significantly correlated with the patient-reported outcomes. Conclusions: Digital measures of turning, but not gait, were different in fallers compared to non-fallers with PD, in the laboratory when off medication and during a daily life.

Original languageEnglish (US)
JournalMovement Disorders Clinical Practice
DOIs
StateAccepted/In press - 2022

Keywords

  • clinic
  • daily life
  • levodopa
  • mobility
  • Parkinson's disease

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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