Experimental Brain Research

, Volume 177, Issue 3, pp 336–346 | Cite as

Gait asymmetry in patients with Parkinson’s disease and elderly fallers: when does the bilateral coordination of gait require attention?

  • Galit Yogev
  • Meir Plotnik
  • Chava Peretz
  • Nir Giladi
  • Jeffrey M. Hausdorff
Research Article


While it is known that certain pathologies may impact on left–right symmetry of gait, little is known about the mechanisms that contribute to gait symmetry or how high in the hierarchy of the control of gait symmetry is regulated in humans. To assess the contribution of cognitive function to gait symmetry, we measured gait asymmetry (GA) in three subject groups, patients with Parkinson’s disease (PD, n = 21), idiopathic elderly fallers (n = 15), and healthy elderly controls (n = 11). All subjects walked under two walking conditions: usual walking and dual tasking (cognitive loading) condition. For each subject, the swing time (SW) was calculated and averaged across strides for the left and right feet (SWL and SWR). GA was defined as: \( 100 \times {\left| {\ln ({\text{SWR}}/{\text{SWL}})} \right|.} \) For both the PD patients and the elderly fallers GA values were significantly higher during the usual walking condition, as compared with the control group (< 0.01). In addition, for both the PD patients and the elderly fallers, GA significantly increased when they walked and performed a dual task, compared with the usual walking condition (< 0.003). In contrast, dual tasking did not affect the GA of the healthy controls (= 0.518). GA was associated with gait speed and gait variability, but no correlations were found between GA and the asymmetry of the classic PD motor symptoms. Thus, the results suggest that the ability to generate a steady, rhythmic walk with a bilaterally coordinated gait does not rely heavily on mental attention and cognitive resources in healthy older adults. In contrast, however, when gait becomes impaired and less automatic, GA apparently relies on cognitive input and attention.


Asymmetry Bilateral coordination Gait Cognitive function Dual tasking 



This work was supported in part by the National Parkinson Foundation, the Parkinson’s Disease Foundation, and by National Institutes of Health grants AG-14100, RR-13622, HD-39838 and AG-08812. We thank Shmuel Springer, Talia Herman and Leor Gruendlinger for invaluable assistance and the participants for their time and effort.


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Galit Yogev
    • 1
  • Meir Plotnik
    • 1
  • Chava Peretz
    • 1
    • 2
  • Nir Giladi
    • 1
    • 2
    • 4
  • Jeffrey M. Hausdorff
    • 1
    • 2
    • 3
    • 5
  1. 1.Movement Disorders Unit, Neurology DepartmentTel-Aviv Sourasky Medical CenterTel-AvivIsrael
  2. 2.Department of Physical Therapy, Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael
  3. 3.Division on AgingHarvard Medical SchoolBostonUSA
  4. 4.Department of Neurology, Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael
  5. 5.Laboratory for Gait Analysis and Neurodynamics, Movement Disorders UnitTel-Aviv Sourasky Medical CenterTel-AvivIsrael

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