Use of three-dimensional gait analysis to assess the effectiveness of conventional rehabilitation protocols in people with Parkinson's disease

Objectives: to assess the effectiveness of a 5-weeks rehabilitation protocol on people with Parkinson's Disease (PD) on the basis of spatio-temporal and kinematics parameters obtained from three-dimensional gait analysis. Methods: twenty-six individuals with PD (21 male, 5 female, age 70.3±8.9, H&Y 2.0±0.5) underwent a rehabilitation treatment (5 weeks, 2 45-mi- nutes sessions/week) focused on balance, posture and gait training enhanced by rhythmic auditory stimulation. The participants were also requested to self-administer the same exercises while at home 3 sessions/ week. Gait patterns were analyzed before and after rehabilitation using quantitative gait analysis performed with an optoelectronic system composed by eight 120 Hz cameras (BTS Smart, Italy). Spatio-temporal and kinematic data were examined. Results: after rehabilitation we found increased cadence (119.2 vs 113.5 steps/min, p1⁄40.012), velocity (1.14 vs. 1.04 m/s, p1⁄40.018), step length (0.57 vs. 0.50 m, p1⁄40.002), swing phase duration (40.1 vs. 38.5%, p1⁄40.005) and reduced double support phase (10.4 vs. 11.9%, p1⁄40.006). In contrast, as regards the kinematics the only significant improvement was found on dynamic ROM of hip (pre 39.1 , post 41.7 , p1⁄40.009). Conclusions: the use of three-dimensional gait analysis allows to accu- rately assessing the effect of rehabilitation on people with PD. In the specific case, the results show that conventional rehabilitation is effective in improving the spatio-temporal parameters of gait, but not kinematics. This fact probably reflect a widespread vision of gait rehabilitation in PD where primary attention is given on restoring suitable values of velocity, step length and cadence which are the features primarily altered by the disease.