Gait alterations on irregular surface in people with Parkinson's disease.

Background: Persons with Parkinson's disease are at high risk for fall-related injuries with a large proportion of falls occurring while walking, especially when the walking environments are complex. The aim of this study was to characterize gait parameters on irregular surface for persons with Parkinson's disease.
Methods: Three-dimensional gait analysis was conducted for nine persons with Parkinson's disease and nine healthy age-matched adults on both regular and irregular surfaces. Repeated ANOVA and paired t-test were performed to determine the effect of surface and group for spatiotemporal, kinematic and stability variables.
Findings: Individuals with Parkinson's disease showed a larger ratio of reduction for speed, cadence and step length than controls when the surface changed from regular to irregular. The ankle transverse range of motion and root mean square of trunk acceleration increased on irregular surface for both groups. Additionally, individuals with Parkinson's disease demonstrated a decreased knee sagittal range of motion and trunk frontal and transverse range of motion compared with controls, especially on the irregular surface.
Interpretation: The irregular surface posed a greater challenge to maintain balance and stability for individuals with Parkinson's disease. A relatively small knee range of motion in the sagittal plane and large root mean square of trunk acceleration increased the potential fall risk for individuals with Parkinson's disease. This information improves the understanding of parkinsonian gait adaptations on irregular surfaces and may guide gait training and rehabilitation interventions for this high fall-risk population.
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