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Stride width and postural stability in frontal gait disorders and Parkinson’s disease

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Abstract

Older adults, as well as those with certain neurological disorders, may compensate for poor neural control of postural stability by widening their base of foot support while walking. However, the extent to which this wide-based gait improves postural stability or affects postural control strategies has not been explored. People with idiopathic Parkinson’s disease (iPD, n = 72), frontal gait disorders (FGD, n = 16), and healthy older adults (n = 32) performed walking trials at their preferred speed over an 8-m-long, instrumented walkway. People with iPD were tested in their OFF medication state. Analyses of covariance were performed to determine the associations between stride width and measures of lateral stability control. People with FGD exhibited a wide-based gait compared to both healthy older adults and iPD. An increased stride width was associated with an increase in lateral margin of stability in FGD. Unlike healthy older adults or iPD, people with FGD did not externally rotate their feet (toe-out angle) or shift their center of pressure laterally to aid lateral dynamic stability during walking but slowed their gait instead to increase stability. By adopting a slow, wide-based gait, people with FGD take advantage of the passive, pendular mechanics of walking.

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Abbreviations

b z :

Offset in lateral direction

b min :

Minimum margin of stability during single leg stance

CoM:

Center of mass, coordinates (x, y, z)

CoP:

Center of pressure, coordinates (ux, 0, uz)

∆u z :

Most lateral minus initial position of the CoP during single stance

G :

Acceleration of gravity (9.81 m s−2)

L :

Pendulum length

v z :

CoM velocity in lateral direction

ω 0 :

Eigenfrequency of pendulum = \(\sqrt {g/l}\)

XcoM:

Extrapolated center of mass, coordinates (\(\xi\), 0, \(\zeta\))

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Funding

This work was supported by the National Institutes of Health (2R01AG006457). Carolin Curtze was supported by the Center of Biomedical Research Excellence grant (P20GM109090) from NIGMS/NIH, and by a NASA EPSCoR grant (80NSSC18M0076). Marian L. Dale receives research support from the NIH (K23NS121402-01).

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Authors and Affiliations

  1. Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, 68182, USA

    Carolin Curtze

  2. Department of Neurology, Oregon Health and Science University, Portland, OR, USA

    Vrutangkumar V. Shah, Alexa M. Stefanko, Marian L. Dale, John G. Nutt, Martina Mancini & Fay B. Horak

  3. APDM Wearable Technologies-a Clario Company, Portland, OR, USA

    Vrutangkumar V. Shah & Fay B. Horak

  4. PADRECC, Portland VA Medical Center, Portland, OR, USA

    Marian L. Dale

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  1. Carolin Curtze
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Contributions

CC: study design, data analysis, figures, statistical analysis, drafting manuscript, literature search. VVS: statistical analysis, interpretation of results, revise manuscript. AMS: figures, statistical analysis, revise manuscript. MLD: study design, screen subjects, interpretation of results, drafting manuscript, literature search. JGN: study design, screen subjects, interpretation of results, revise manuscript. MM: study design, supervise project, interpretation of results, revise manuscript. FBH: study design, supervise project, interpretation of results, revise manuscript. All authors approved the final version.

Corresponding author

Correspondence to Carolin Curtze.

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Conflicts of interest

Carolin Curtze has no conflict of interest to report. Vrutangkumar V Shah is employed by APDM Wearable Technologies of Clario that may have a commercial interest in the results of this research and technology. This potential conflict of interest has been reviewed and managed by OHSU. Alexa M Stefanko has no conflict of interest to report. Marian L. Dale has served as a consultant for Synergic Medical Technologies and Cognito Therapeutics. John G Nutt has no conflict of interest to report for this work. Martina Mancini has no conflict of interest to report for this work. Fay B Horak is employed part-time by APDM Wearable Technologies of Clario that may have a commercial interest in the results of this research and technology. This potential conflict of interest has been reviewed and managed by OHSU.

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Curtze, C., Shah, V.V., Stefanko, A.M. et al. Stride width and postural stability in frontal gait disorders and Parkinson’s disease. J Neurol (2024). https://doi.org/10.1007/s00415-024-12401-5

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