Maximum Step Length Test Performance in People With Parkinson Disease: A Cross-sectional Study.
Ryan P Duncan, Marie E McNeely, Gammon M Earhart
PMID 28922312WHAT IT FOUND
People with Parkinson disease step significantly shorter backward than forward or sideways.
Medication improves step length slightly, but the change is too small to be clinically meaningful. The test correlates strongly with balance and walking endurance measures.
Key findings
01Participants stepped significantly further in the forward direction compared to backward and lateral directions.
02Stepping distance increased when participants were on medication compared to off, but the difference was less than 5 centimeters.
03Maximum Step Length Test performance correlated strongly with the Mini-BESTest and the 6 Minute Walk Test.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was small and consisted mostly of people with mild disease who did not have postural instability, so results may not apply to patients with more advanced symptoms. The OFF medication test was always done before the ON medication test, so practice effects could have influenced the results. The examiner was not blinded to the medication status. The study did not include enough participants with a history of falls to analyze the test's ability to predict fall risk.
Declared interests
The study was conducted within a larger exercise trial. No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the statistically significant improvement in step length when ON medication as a clinically meaningful benefit. The change was less than 5 centimeters, which is below the minimal detectable change of 18.6 centimeters, meaning it could easily be measurement error or practice effect rather than a true drug effect.