The poster “Gait analysis as a complementary tool in the levodopa dose decision in vascular Parkinson’s disease” was presented at the 21st International Congress of Parkinson’s Disease and Movement Disorders, in Vancouver from the 4th to the 8th of June.
Dr. Miguel Gago (Hospital da Senhora da Oliveira, Guimarães, University of Minho, ICVS-3Bs PT Government Associate Laboratory, Portugal), used GaitUp® system to evaluate the role of objective gait analysis in the decision of levodopa dose in patients with vascular Parkinsonism (VPD), in particular when compared to clinical assessment and concluded that “gait analysis may prove to be an complementary tool in the individualized decision of the levodopa dose in VPD”.
Patients with vascular Parkinsonism (VPD) were evaluated in “Off” phase (24h without L-dopa) and in “On” phase (after a suprathreshold L-dopa challenge, 150% of L-dopa morning dose), with MDS-UPDRS (part III) and gait analysis (GaitUp®) (60-meter continuous course in a self-selected walking speed).
Clinical scores and spatial, temporal and clearance gait variables were statistically compared (“Off” vs. “On” phase). Kinematic gait variables did not correlate with the magnitude of change (%) observed in the MDS-UPDRS-III (+12% [4, 23]) and rigidity (+25% [0, 42]) scores. After medication, patients showed statistically significant median change (%) (left/right foot) in: gait velocity (+9.9%/+8.3%);stride length (+8.3%/+5.9%); foot-flat (-1.5%/-1.3%) and pushing (+6.3%/+3.8%) as a percent of stance time; and peak angle velocity (+5.1%/+4.1%).
The author concludes that “Increased doses of levodopa (50% extra), albeit with apparent clinical benefit in bradykinesia and rigidity, do not necessarily translate into an equivalent benefit in gait profile” and that “Gait can be a complementary tool in the individualized decision of levodopa dose in VPD.”