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Since Parkinson’s Disease (PD) is a neurodegenerative disorder that impacts both motor and sensory systems, this can manifest as changes in the way you walk. Gait analysis for patients with PD is particularly important as these changes are often suboptimal and make it more difficult to walk. The good news is that physical therapists can use information learned from gait analysis to help identify the areas a person can improve upon when they are walking, preserving their independence and reducing their risk for falls.
Some of the gait, or walking, changes that can occur with PD are:
1. Smaller, Shuffling Steps
Referred to as a festinating gait pattern, this is when an individual takes shorter steps and often does not clear the ground as much in a shuffling manner. These smaller steps are involuntary and can get shorter and faster as the individual continues to walk. This gait pattern is often paired with a “stooped posture” in which the trunk and shoulders are rounded forward.
2. Lack of Proper Heel Strike
In a typical gait pattern, when you take a step the heel makes contact with the ground first. With PD, the foot lands flat on the ground with each step, hindering efficient foot movement and forward propulsion.
3. Narrow Base of Support
With PD, people often bring their feet closer together, narrowing their base of support during walking which makes them more unstable and prone to falls.
4. Less Trunk Movement and Arm Swing
Those with PD often demonstrate less rotation at the trunk and hold their arms still when they walk, as opposed to the normal reciprocal swaying of arms that should occur with each step. This contributes to a more stiff, less fluid walk pattern.
5. Trouble Turning and Episodes of Freezing
Turns are particularly difficult for those with PD as this involves initiation of movement in another direction. Freezing occurs when the person is unable to continue moving forward and appears to stop mid-walk or movement. Freezing is particularly common during turns or when negotiating obstacles and puts the person at an increased risk for falls.
6. Difficulty with Multi-Tasking
Depending on the progression of the disease, some individuals have extreme difficulty performing other tasks or concentrating during walking. The quality of their walk might change if they engage in conversation, try to bounce a ball, or become distracted by the environment. This can be particularly hazardous and increase the risk of falls during walking, especially in busy environments.
7. Potential Need for Assistive Device
As the disease progresses, a physical therapist might decide it is safest for the patient to implement the use of an assistive device to provide balance support, prevent excessive fatigue, reduce the risk of falls, and allow for safe independence with mobility.
While it can be very difficult for individuals with PD to consciously correct these gait deviations on their own, physical therapists work with them to address the underlying impairments and promote motor learning to improve balance and gait. The use of rhythmic cueing, such as a metronome, and visual cues on the floor, like tape marks, can help patients take steps with appropriate pacing and length. There are a variety of tactics and exercises physical therapists are skilled in utilizing that have been shown to successfully help those with PD improve their balance, posture, and gait.
Looking to improve your walk? Download the OneStep Digital Physical Therapy app to consult with a licensed physical therapist and receive a free gait analysis today!
Resources
Understanding Parkinson's. Parkinson’s Foundation. Updated 2022. Accessed April 4, 2022.
