Footsteps and walking trajectories during the Timed Up and Go test in young, older, and Parkinson’s disease subjects

•A laser system can easily assess footsteps and walking trajectories in TUG.•People with PD regardless of FOG turned close to the TUG marker.•Turning close to the marker in PD was related to short step length when turning.•Healthy older people turned using the large depth of space behind the marker....

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Published inGait & posture Vol. 89; pp. 54 - 60
Main Authors Okada, Yohei, Yorozu, Ayanori, Fukumoto, Takahiko, Morioka, Shu, Shomoto, Koji, Aoyama, Tomoki, Takahashi, Masaki
Format Journal Article
LanguageEnglish
Published Elsevier B.V 01.09.2021
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Abstract •A laser system can easily assess footsteps and walking trajectories in TUG.•People with PD regardless of FOG turned close to the TUG marker.•Turning close to the marker in PD was related to short step length when turning.•Healthy older people turned using the large depth of space behind the marker. Footsteps and walking trajectories during the Timed Up and Go test (TUG), and their relationships with spatiotemporal gait parameters during turning in people with Parkinson’s disease (PD) and older people have not been clarified. We investigated the footsteps, walking trajectories, and spatiotemporal parameters during the TUG in PD, healthy older (HO), and healthy young (HY) subjects and the associations between the parameters of footsteps or walking trajectories and the spatiotemporal parameters during turning. Twenty-six PD, 20 HO, and 20 HY subjects participated. They performed the TUG at self-selected speed and underwent evaluations of spatiotemporal parameters in the forward, turning, and return phases and parameters of footsteps and walking trajectories by a system using laser range sensors to measure the two-dimensional distance data of the legs. Foot placement for each foot was measured as the estimated position when the leg speed of movement reached the minimum between foot-contact and foot-off. We calculated the minimum distance from a TUG marker to footsteps and the maximum anterior distance from the start to the footsteps. Step length was calculated using a method for non-linear walking. The PD subjects showed significantly smaller step lengths in all phases. The minimum distance from the marker to the footsteps in PD subjects was significantly smaller than in HO subjects and was significantly positively correlated only with the turning-phase step length. The maximum anterior distance from the start to footsteps in HO subjects was significantly larger than in PD and HY subjects and was not correlated with any spatiotemporal parameters. This study demonstrated that people with PD turn close to the TUG marker, and this turning strategy may be associated with the decreased step length when turning. These findings could help in providing instructions which prevent the exaggeration of step-length reduction when turning.
AbstractList •A laser system can easily assess footsteps and walking trajectories in TUG.•People with PD regardless of FOG turned close to the TUG marker.•Turning close to the marker in PD was related to short step length when turning.•Healthy older people turned using the large depth of space behind the marker. Footsteps and walking trajectories during the Timed Up and Go test (TUG), and their relationships with spatiotemporal gait parameters during turning in people with Parkinson’s disease (PD) and older people have not been clarified. We investigated the footsteps, walking trajectories, and spatiotemporal parameters during the TUG in PD, healthy older (HO), and healthy young (HY) subjects and the associations between the parameters of footsteps or walking trajectories and the spatiotemporal parameters during turning. Twenty-six PD, 20 HO, and 20 HY subjects participated. They performed the TUG at self-selected speed and underwent evaluations of spatiotemporal parameters in the forward, turning, and return phases and parameters of footsteps and walking trajectories by a system using laser range sensors to measure the two-dimensional distance data of the legs. Foot placement for each foot was measured as the estimated position when the leg speed of movement reached the minimum between foot-contact and foot-off. We calculated the minimum distance from a TUG marker to footsteps and the maximum anterior distance from the start to the footsteps. Step length was calculated using a method for non-linear walking. The PD subjects showed significantly smaller step lengths in all phases. The minimum distance from the marker to the footsteps in PD subjects was significantly smaller than in HO subjects and was significantly positively correlated only with the turning-phase step length. The maximum anterior distance from the start to footsteps in HO subjects was significantly larger than in PD and HY subjects and was not correlated with any spatiotemporal parameters. This study demonstrated that people with PD turn close to the TUG marker, and this turning strategy may be associated with the decreased step length when turning. These findings could help in providing instructions which prevent the exaggeration of step-length reduction when turning.
BACKGROUNDFootsteps and walking trajectories during the Timed Up and Go test (TUG), and their relationships with spatiotemporal gait parameters during turning in people with Parkinson's disease (PD) and older people have not been clarified. RESEARCH QUESTIONWe investigated the footsteps, walking trajectories, and spatiotemporal parameters during the TUG in PD, healthy older (HO), and healthy young (HY) subjects and the associations between the parameters of footsteps or walking trajectories and the spatiotemporal parameters during turning. METHODSTwenty-six PD, 20 HO, and 20 HY subjects participated. They performed the TUG at self-selected speed and underwent evaluations of spatiotemporal parameters in the forward, turning, and return phases and parameters of footsteps and walking trajectories by a system using laser range sensors to measure the two-dimensional distance data of the legs. Foot placement for each foot was measured as the estimated position when the leg speed of movement reached the minimum between foot-contact and foot-off. We calculated the minimum distance from a TUG marker to footsteps and the maximum anterior distance from the start to the footsteps. Step length was calculated using a method for non-linear walking. RESULTSThe PD subjects showed significantly smaller step lengths in all phases. The minimum distance from the marker to the footsteps in PD subjects was significantly smaller than in HO subjects and was significantly positively correlated only with the turning-phase step length. The maximum anterior distance from the start to footsteps in HO subjects was significantly larger than in PD and HY subjects and was not correlated with any spatiotemporal parameters. SIGNIFICANCEThis study demonstrated that people with PD turn close to the TUG marker, and this turning strategy may be associated with the decreased step length when turning. These findings could help in providing instructions which prevent the exaggeration of step-length reduction when turning.
Author Okada, Yohei
Fukumoto, Takahiko
Shomoto, Koji
Takahashi, Masaki
Aoyama, Tomoki
Yorozu, Ayanori
Morioka, Shu
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  surname: Okada
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  organization: Graduate School of Health Sciences, Kio University, Nara, 635-0832, Japan
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  givenname: Ayanori
  surname: Yorozu
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  email: ayanoriyorozu@keio.jp
  organization: Graduate School of Science and Technology, Keio University, Yokohama, 223-8522, Japan
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  givenname: Takahiko
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  fullname: Fukumoto, Takahiko
  email: t.fukumoto@kio.ac.jp
  organization: Graduate School of Health Sciences, Kio University, Nara, 635-0832, Japan
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  givenname: Shu
  surname: Morioka
  fullname: Morioka, Shu
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  surname: Shomoto
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  organization: Graduate School of Health Sciences, Kio University, Nara, 635-0832, Japan
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  givenname: Tomoki
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  fullname: Aoyama, Tomoki
  email: aoyama.tomoki.4e@kyoto-u.ac.jp
  organization: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
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  givenname: Masaki
  surname: Takahashi
  fullname: Takahashi, Masaki
  email: takahashi.z6@keio.jp
  organization: Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, 223-8522, Japan
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Keywords Walking trajectory
Turning
Footstep
Timed Up and Go test
Parkinson’s disease
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Snippet •A laser system can easily assess footsteps and walking trajectories in TUG.•People with PD regardless of FOG turned close to the TUG marker.•Turning close to...
BACKGROUNDFootsteps and walking trajectories during the Timed Up and Go test (TUG), and their relationships with spatiotemporal gait parameters during turning...
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SubjectTerms Footstep
Parkinson’s disease
Timed Up and Go test
Turning
Walking trajectory
Title Footsteps and walking trajectories during the Timed Up and Go test in young, older, and Parkinson’s disease subjects
URI https://dx.doi.org/10.1016/j.gaitpost.2021.06.021
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