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Subtle gait and cognitive dysfunction are common in Parkinson's disease (PD), even before most evident clinical manifestations. Such alterations can be assumed as hypothetical phenotypical and prognostic/progression markers. To compare spatiotemporal gait parameters in PD patients with three cognitive status: cognitively intact (PD-noCI), with subjective cognitive impairment (PD-SCI) and with mild cognitive impairment (PD-MCI) in order to detect subclinical gait differences. One hundred PD patients were consecutively enrolled and divided in three groups based on both the first item od MDS-UPDRS part I and an extensive neuropsychological evaluation: 41 PD-noCI, 15 PD-SCI and 44 PD-MCI. They were evaluated with gait analysis acquired in three different conditions (normal gait, motor and cognitive dual task). Spatiotemporal variables were extracted. A univariate statistical analysis (parametric ANOVA test or non-parametric Kruskal-Wallis test, as appropriate) with post-hoc analysis was carried out in order to evaluate the significant differences among the groups. In normal gait task, the three groups showed several differences, all due to the comparison between PD-MCI and PD-noCI, as disclosed by post-hoc analysis. In dual task conditions, mostly in the cognitive dual task, the three groups showed increased gait alterations that, at post-hoc analysis, mirrored the magnitude of cognitive dysfunction (PD-noCI < PD-SCI < PD-MCI). Peculiar prodromal gait patterns-especially those highlighted by cognitive dual task-could be considered possible markers to objectify self-reported symptoms-based construct, like SCI, and to early intercept subjects with different clinical evolutions and prognoses, even representing an innovative clustering/phenotyping tool for PD subtypes., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical standards: All people recruited for the study gave their informed consent prior to their inclusion. All acts were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments., (© 2025. The Author(s).)

Parkinson's disease (PD) is characterized by a slow, short-stepping, shuffling gait pattern caused by a combination of motor control limitations due to a reduction in dopaminergic neurons. Gait disorders are indicators of global health, cognitive status, and risk of falls and increase with disease progression. Therefore, the use of quantitative information on the gait mechanisms of PD patients is a promising approach, particularly for monitoring gait disorders and potentially informing therapeutic interventions, though it is not yet a well-established tool for early diagnosis or direct assessment of disease progression. Over the years, many studies have investigated the spatiotemporal parameters that are altered in the PD gait pattern, while kinematic and kinetic gait parameters are more limited. A scoping review was performed according to the PRISMA guidelines. The Scopus and PubMed databases were searched between 1999 and 2023. A total of 29 articles were included that reported gait changes in PD patients under different gait conditions: single free walking, sequential motor task, and dual task. The main findings of our review highlighted the use of optoelectronic systems for recording kinematic parameters and force plates for measuring kinetic parameters, due to their high accuracy. Most gait analyses in PD patients have been conducted at self-selected walking speeds to capture natural movement, although studies have also examined gait under various conditions. The results of our review indicated that PD patients experience alterations in the range of motion of the hip, knee, and ankle joints, as well as a reduction in the power generated/absorbed and the extensor/flexor moments. These findings suggest that the PD gait pattern may be more effectively understood using kinematic and kinetic parameters.