Gait variability in Parkinson's disease: levodopa and walking direction

Background: Levodopa treatment has been shown to improve gait spatio-temporal characteristics in both forward and backward walking. However, effect of levodopa on gait variability during backward walking compared with forward walking has not been reported.

Aims of study: To study the effects of levodopa on gait variability of forward and backward walking in individuals with Parkinson's disease (PD).

Methods: Forty individuals with PD were studied. Their mean age was 68.70 ± 7.46 year. The average time since diagnosis was 9.41 ± 5.72 year. Gait variability was studied while 'OFF' and 'ON' levodopa when the participants walked forward and backward at their usual speed. Variability in step time, swing time, stride length, double support time, and stride velocity were compared between medication condition and walking direction.

Results: Variability of step time, swing time, stride length, and stride velocity decreased significantly during forward and backward walks (P < 0.001; P < 0.001; P = 0.003, P = 0.001, respectively) after levodopa administration. Variability of double support time was not changed after levodopa administration (P = 0.054).

Conclusions: Levodopa had positive effects on gait variability of forward and backward walking in individuals with PD. However, variability in double support time was not affected by the levodopa.