Objective: Parkinson's disease (PD) is a progressive neurological disorder resulting from the degeneration of dopaminergic neurons, impacting movement control, and affecting millions worldwide. Understanding gait coordination in PD is crucial for effective rehabilitation. This study aimed to compare inter-joint coordination during gait between people with PD and healthy controls.
Methods: Fifteen PD patients and 17 healthy individuals aged 50-70 years participated in this study. Using a motion capture system, data were recorded from reflective markers placed on specific anatomical landmarks of the thigh, shank, and foot on both sides as participants walked at a self-selected speed. Throughout the entire gait cycle, various coordination modes-including in-phase (IP), anti-phase (AP), proximal-phase (PP), and distal-phase (DP)-were thoroughly analyzed using the vector coding technique. This study employed a two-factor design with the plane (sagittal, frontal, and horizontal) and foot (right and left) as factors. Between-group differences were analyzed using one-way ANOVA to identify variations in coordination patterns across the groups.
Results: Significant differences in joint coordination were observed between groups. In ankle-hip coordination, differences appeared in the sagittal plane during loading and swing phases, the frontal plane during push-off, and the horizontal plane during bilateral push-off. For ankle-knee coordination, the control group showed higher coupling angles during the sagittal loading phase and frontal swing and loading phases. In knee-hip coordination, the PD group exhibited larger coupling angles in the sagittal plane during mid-stance, loading, and push-off phases, while significant differences in the horizontal plane were noted during push-off.
Conclusion: These findings suggest that individuals with PD show altered inter-joint coordination patterns, particularly in proximal joints, likely due to impaired balance. This new understanding can inform rehabilitation interventions, such as targeted therapies to improve proximal joint coordination and gait stability. Further research is needed to explore clinical studies for optimizing rehabilitation strategies.