AUTHOR=Navratilova Daniela , Krobot Alois , Otruba Pavel , Nevrly Martin , Krahulik David , Kolar Petr , Kolarova Barbora , Kaiserova Michaela , Mensikova Katerina , Vastik Miroslav , Kurcova Sandra , Kanovsky Petr 

TITLE=Deep Brain Stimulation Effects on Gait Pattern in Advanced Parkinson’s Disease Patients

JOURNAL=Frontiers in Neuroscience

VOLUME=Volume 14 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2020.00814

DOI=10.3389/fnins.2020.00814

ISSN=1662-453X

ABSTRACT=Background: Gait disturbance accompanies many neurodegenerative diseases; it is characteristic for Parkinson’s disease (PD). Treatment of advanced PD often includes deep brain stimulation (DBS) of the subthalamic nuclueus. Regarding gait, previous studies have reported non-significant or conflicting results, possibly related to methodological limitations. 
Objective: The objective of this prospective study was to assess the effects of DBS on biomechanical parameters of gait in patients with PD.
Methods: Twenty one patients with advanced PD participated in this prospective study. Gait was examined in all patients using the Zebris FDM-T pressure-sensitive treadmill (Isny, Germany) before DBS implantation and after surgery both immediately, further immediately after the start of neurostimulation and three months after neurostimulator activation. We assessed spontaneous gait on a moving treadmill at different speeds. Step length, stance phase of both lower limbs, double stance phase and cadence were evaluated.
Results: In this study, step length increased, allowing the cadence to decrease. Double stance phase duration i.e., the most sensitive parameter of gait quality and unsteadiness, was reduced, in gait at a speed of 4.5 km/h and in the narrow-based gaits at 1 km/h (tandem gait), which demonstrates improvement. 
Conclusion: This study suggests positive effects of DBS treatment on gait in PD patients. Improvement was observed in several biomechanical parameters of gait.