AUTHOR=De Pasquale Paolo , Bonanno Mirjam , De Marchis Cristiano , Pergolizzi Luca , Lombardo Facciale Antonino , Paladina Giuseppe , Maggio Maria Grazia , Impellizzeri Federica , Ciancarelli Irene , Quartarone Angelo , Calabrò Rocco Salvatore 

TITLE=Beyond clinical scales: an observational study on instrumental gait analysis and biomechanical patterns in patients with Parkinson’s disease

JOURNAL=Frontiers in Bioengineering and Biotechnology

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.2025.1541240

DOI=10.3389/fbioe.2025.1541240

ISSN=2296-4185

ABSTRACT=IntroductionParkinson’s disease (PD), a common neurodegenerative disorder affecting motor functions, is associated with abnormal gait patterns characterized by altered kinematic, kinetic, and electrophysiological parameters. This observational study aims to instrumentally identify and quantify these gait dysfunctions in PD patients compared to normal values from healthy subjects.MethodsSixty-nine PD patients underwent clinical and instrumental evaluations to assess gait. Demographic and clinical data were collected before motor assessment. Clinical scales evaluated the level of impairment, gait, balance, risk of falls and ability to complete activities of daily living. Instrumental evaluations were conducted using optoelectronic, force plates and electromyographic (EMG) systems in a motion analysis laboratory. Statistical analysis involved a non-parametric test to compare pathological and normal data, clustering methods to identify groups based on clinical evaluations, and a combination of non-parametric analysis and linear models to assess dependencies on clinical scales.ResultsThe results showed that PD patients had significant gait kinematic differences compared to normal values, with increased temporal and shortened spatial parameters. In addition, PD patients were grouped into four clusters based on clinical scales. While some gait features were influenced by clinical scales reflecting impairment, gait and balance, and independence, others were more affected by the perceived fear of falling (FoF).DiscussionIn conclusion, the study identified specific biomechanical gait dysfunctions in kinematic, kinetic, and electrophysiological parameters in PD patients, undetectable by standard clinical scales. Additionally, higher FoF was associated with dysfunctional biomechanical patterns, independent of impairment severity, gait and balance dysfunction, or overall independence.