Rhythmic Movement Sequences Elicit Impaired Gait Modulation Ability in Older Adults with Parkinson's Disease

Research Objectives To compare the ability of older adults with and without Parkinson's Disease (PD) to modulate spatiotemporal features of gait using novel Rhythmic Movement Sequences (RMS). Design An observational 2-group cohort pilot study. Setting Participants completed RMS assessments during two, 3-hour visits in a health center assessment space. Participants Older adults with mild-to-moderate (PD, n = 4, 3M/1F; Hoehn and Yahr score range: 1.5-2.5) and without PD (OA, n = 10, 3M/7F) participated (Enrolled/Contacted: 4/4 PD, 10/∼250 OA). Participants did not differ in age (PD: 71.5 ± 5.0y, OA: 70.4 ± 6.6y) or other clinical and demographic characteristics including height, weight, years of education, or comorbidities (all p>0.45). Interventions N/A. Main Outcome Measures We recently developed RMS: a library of multi-step movements incorporating ballet-based positions and steps to varied rhythms to induce non-stereotypical kinematics during swing and stance phases of gait. Participants performed 22 RMS overground: 9 spatial (e.g., modified lower-extremity coordination), 9 temporal (e.g., modified step timing), and 4 spatiotemporal modified gait patterns. Kinematic data were recorded using wearable sensors. For each modification, participants’ performance on each RMS was computed as average percent error in kinematics or step timing relative to biomechanical or temporal targets, respectively. We computed overall RMS performance errors for each gait modification domain, then used t-tests to compare group-wise performance. Results PD performed spatial modifications less accurately than OA (PD: 32.4 ± 4.8%, OA: 26.5 ± 1.7%, p=0.008). PD and OA performed similarly on temporal (PD: 19.5 ± 7.5%, OA: 20.1 ± 7.1%) and spatiotemporal (PD: 32.3 ± 5.3%, OA: 29.7 ± 2.1%) modifications (p>0.41). PD deficits were apparent during RMS requiring swing phase (p=0.014, Cohen's d=-1.5), and combined swing and stance phase (p=0.010, Cohen's d=-1.6) modulation. Conclusions The ability of RMS to elicit spatial gait modulation limitations in this 4-person PD group informs continued development of RMS training to innovatively enhance gait flexibility and mobility in older adults with PD. More research is warranted. Author(s) Disclosures All authors have no conflicts of interest to declare.