Affiliation:
1. Department of Neurology Guangdong Second Provincial General hospital Guangzhou Guangdong China
2. The Second School of Clinical Medicine Southern Medical University Guangzhou Guangdong China
3. Institute for Healthcare Artificial Intelligence Application Guangdong Second Provincial General Hospital Guangzhou Guangdong China
4. Guangdong Second Provincial General hospital, Alzheimer's Disease Clinical Research Center Guangzhou Guangdong China
5. School of Basic Medical Sciences Shenzhen University Shenzhen Guangdong China
Abstract
AbstractBackgroundPostural instability and gait disorder dominant (PIGD) is one of the most common disabling symptoms of Parkinson's disease (PD), which seriously affects patients’ quality of life. Therefore, it is essential to identify PIGD and develop targeted interventions to reduce the risk of PIGD in PD patients.Aim:This study aimed to investigate the gait characteristics of PD patients based on wearable devices and to establish a predictive model for their related influencing factors.MethodsThe retrospective medical records of patients from January 2020 to September 2023 were collected, including 159 patients with PD (divided into PIGD [n = 73] and non‐PIGD [n = 86] groups) and 200 healthy patients (as the healthy control group). Information from social demographic data, a blood test, scale scores, gait analysis based on wearable devices, white matter lesions, and the Fazekas scale was extracted and analyzed.ResultsCompared with the healthy control group, the mean step length, mean rate, mean angular velocity, and step length were lower in the PD group, while the mean steps were higher in the turning test. The incidence of PIGD was 46% in PD patients, and PD patients with the non‐tremor onset mode were more likely to develop PIGD than those with the tremor onset mode. Compared to the non‐PIGD group, the PIGD group showed more serious gait problems in different experimental tasks and had a higher Hoehn and Yahr (H‐Y) stage, Hamilton Anxiety Scale (HAMA) score, Hamilton Depression Scale score, periventricular white matter (PVWM) score, deep white matter score, and Fazekas scale score, but they had lower hemoglobin levels, D‐dimer levels, Tinetti Balance scores, Tinetti Gait scores, Berg Balance Scale scores, and Mini‐Mental State Examination (MMSE) scores. Logistic regression analysis showed that the MMSE score was negatively correlated with the occurrence of PIGD, while the HAMA score, H‐Y stage, PVWM score, and non‐tremor form of onset were positively correlated with the occurrence of PIGDConclusionThe incidence of gait disorder in PD patients is higher than that in the normal population. Moreover, cognitive dysfunction, anxiety state, H‐Y stage, PVWM score, and the non‐tremor mode of onset can be considered independent risk factors for PIGD.