Spatiotemporal, kinematic and kinetic gait characteristics in Parkinson's disease compared to healthy individuals: A systematic review with meta-analysis

Background: Gait disorders are frequently reported in individuals with Parkinson's disease (PD). Despite extensive research, the specific gait features affected by PD remain inadequately defined. Therefore, this study aimed to investigate kinematic, kinetic, and spatiotemporal parameters of gait in individuals with PD compared to healthy controls.

Methods: We conducted a systematic review in PubMed, CINAHL, and EMBASE up to March 2024 to retrieve studies assessing adults with PD, which examined gait compared to healthy controls. Two reviewers independently performed the screening process, extrapolation data and quality assessment. Studies were meta-analyzed using original units of measurement (mean difference, MD) to enhance the clinical understanding of the gait characteristics. The level of evidence was provided.

Findings: Thirty-four studies were included (n = 1533 participants with PD and n = 1093 healthy controls). Moderate-to-strong evidence was found for reduced speed (MD:-0.21 m/s, 95 %CI: -0.27; -0.15), stride length (MD:-0.17 m, 95 %CI: -0.25; -0.09), swing time (MD:-1.16 % of gait cycle, 95 %CI: -2.30; -0.02), and sagittal range of motion of the lower limb joints in individuals with PD (hip: MD:-5.39°, 95 %CI: -10.42; -0.37; knee: MD:-11.05°, 95 %CI: -21.88; -0.22; ankle: MD:-4.03°, 95 %CI: -6.37; -1.69). An increase in double support time (MD:0.07 s, 95 %CI: 0.05; 0.10) and a decrease in cadence (MD: -4.93 steps/min, 95 %CI: -7.89; -1.98) were observed. Kinetic data showed diverse outcomes, making a meta-analysis not possible.

Interpretation: PD is associated with changes in gait kinematics and spatiotemporal parameters, while kinetic aspects remain under investigated. Future research should focus on kinetics, joint angular velocity, and push-off parameters. PROSPERO registration: CRD42022347368.