Moving forward on gait measurement: Toward a more refined approach

Authors

  • Sue Lord PhD,

    1. Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, United Kingdom
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  • Brook Galna PhD,

    1. Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, United Kingdom
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  • Lynn Rochester PhD

    Corresponding author
    1. Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, United Kingdom
    • Correspondence to: Dr. Lynn Rochester, Professor of Human Movement Science, Institute for Ageing and Health, Newcastle University, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL United Kingdom; lynn.rochester@ncl.ac.uk

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  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

  • Funding agencies: This research was supported by the National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre based at Newcastle upon Tyne Hospitals National Health Service Foundation Trust and Newcastle University. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

ABSTRACT

Gait is emerging as a powerful measurement tool in neurodegenerative disorders to identify markers of incipient pathology, inform diagnostic algorithms and disease progression, and measure the efficacy of interventions. However, it is unclear which of the many gait outcomes is most appropriate for each of these purposes. In this review, we summarise key topics relating to gait measurement. We draw on literature from Parkinson's disease, ageing, and neurodegenerative disease to address the issue of variable selection with the goal of moving toward a structured approach to measurement. Findings from this review identify a wide range of spatiotemporal and dynamic characteristics; however, their suitability differs according to the aim of measurement. Gait speed is useful as a global characteristic of performance but may not capture the nature of underlying pathology. Inconsistent application, reporting, and interpretation of gait outcomes currently preclude a prescriptive approach. Conceptual models of gait may facilitate a reasoned approach to outcome selection. We also recommend harmonisation of protocols, longitudinal cohort studies, and use of novel technologies and methods of analysis to provide a complete picture of gait. Gait characteristics are “fit for purpose” when selected according to a clear rationale and in accordance with their clinimetric properties. Evidence supports the use of gait as a biomarker of disease and to complement diagnosis and inform disease management. A structured approach to measurement is urgently required to fully realise the contribution gait can make to our understanding of neurodegenerative disease. © 2013 International Parkinson and Movement Disorder Society

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