Impact of deep brain stimulation on gait in Parkinson disease: A kinematic study.
Richa Tripathi, J Lucas McKay, Stewart A Factor and 4 others
PMID 38070393WHAT IT FOUND
Gait speed, step length, and stride length worsened less than a year after deep brain stimulation, even though medication doses dropped and clinical motor scores improved.
These kinematic declines were not predicted by target site or medication changes.
Key findings
01Average gait speed decreased significantly from pre-surgical to post-surgical assessments in the on-medication state.
02Step length, stride length, and cadence also decreased, while total and double support times increased.
03Changes in levodopa equivalent dose did not correlate with the observed decrease in gait speed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
There was no control group of Parkinson's patients who did not undergo surgery, so it is impossible to distinguish whether the gait decline was caused by the intervention or by natural disease progression. The sample size was small (n=22), which limited the power to detect differences between specific stimulation targets (STN vs. GPi) or implant types (unilateral vs. bilateral). Physical therapy status was not controlled or accounted for, meaning concurrent therapy could have influenced gait outcomes. Gait testing was not performed in the 'off medication' state post-surgery, limiting the ability to isolate the direct effect of stimulation on gait. There was a potential sampling bias, as patients who experienced post-operative gait difficulties may have been more motivated to return for testing.
Declared interests
The study was supported by the National Institutes of Health (Extramural) and non-U.S. government sources. No commercial conflicts of interest are reported in the provided text.
The easy way to misread this
Do not interpret the worsening gait metrics as proof that deep brain stimulation directly causes gait decline. The lack of a control group means this decline could simply reflect the natural progression of Parkinson's disease over the 15-month period, rather than a negative effect of the surgery or stimulation.