Nordic walking in Parkinson's disease
Reduced gait speed and arm swing, shorter strides and increased gait variability are typical features of gait in Parkinson's disease (PD). From a temporal point of view, the absence of a steady gait rhythm and the subsequently more random stride-to-stride variability is a primary disorder and a clear indicator of elevated fall risk in PD. As an external form of cueing, Nordic walking (NW) may improve these gait deficits. This study aimed to evaluate the effects of NW on temporal organization of gait variability and spatiotemporal gait variables in PD.
In a cross-sectional study design, 14 patients with mild-to-moderate PD and 10 age-matched controls walked overground at a comfortable speed for two 12-minute sessions. Gait speed, cadence, step length and temporal organization of stride duration variability were measured using a unidimensional accelerometer on the ankle. NW showed signifcantly improved autocorrelations by increasing step length and decreasing cadence. Autocorrelations for temporal organization of stride duration variability, and step length of PD patients during the NW session showed increased similarity to the values of healthy controls.
This study showed that NW may be a valuable tool in the struggle against the randomness of gait in PD. This might be due to the fact that NW involves upper body rhytmic movements acting as a rhytmical external cue to bypass defective basal ganglia circuitries. Future research could look into the longitudinal effects of a NW training program on gait variability and spatiotemporal paramaters of gait in PD.
> From: Warlop et al., J Neuroeng Rehabil 14 (2017) 17. All rights reserved to The Author(s). Click here for the online summary.