24-Hour Recording of Parkinsonian Gait Using a Portable Gait Rhythmogram

OBJECTIVE: In the advanced stage of Parkinson's disease (PD), motor fluctuation is a frequent and a disabling problem. Despite its importance, motor fluctuation has received little scientific analysis probably due to limitation in objective assessment. Here, we focused on gait disorders to estimate motor fluctuation in daily activities. PATIENTS AND METHODS: Using a new device, the portable gait rhythmogram, we recorded gait rhythm continuously over 24 hours in 22 patients with PD and in 11 normal controls, for quantitative evaluation of motor fluctuation. The duration of one gait cycle was measured. RESULTS: Continuous 24-hour recording identified changes in gait rhythm, which correlated with fluctuation of PD symptoms. Different motor fluctuations were observed; a shift to a faster gait cycle was noted in patients with short-step walking, festination or freezing of gait, whereas a shift to a slower gait cycle was observed in patients with bradykinesia or instability. CONCLUSION: Characterization of motor fluctuation using this device could help in the selection of appropriate anti-PD medications.