Gait analysis differentiates progressive supranuclear palsy from Parkinson’s

Gait patterns may help distinguish progressive supranuclear palsy (PSP) from Parkinson’s disease (PD) patients, with the former showing compromised velocity and dynamic stability, a recent study has found.

Researchers enrolled 83 patients with PD and 21 with PSP, whose gaits were measured while standing and while walking along a 10-metre path. Walking gait was measured both as a single task and as a dual task, which involved cognitively preoccupying participants.

Univariate analysis showed that even at the singular walking task, PSP patients had poorer gait patterns than PD comparators. In particular, velocity, cadence, and step and cycle lengths were all shorter in PSP patients, while cycle duration was longer. The cognitive preoccupation worsened gait parameters in both groups.

After excluding outliers, binary logistic regression analysis showed that both the single- and dual-walking tasks had overall accuracies of 73.7 percent and 88.2 percent, respectively, for detecting PSP patients. The corresponding accuracies for PD were 92.3 percent and 95 percent.

In terms of individual gait parameters while unpreoccupied, a longer stance phase correlated with a significantly higher likelihood of having PSP, while longer swing duration, cadence, and cycle length were associated with PD.

Notably, even in the early phases of the disease, PSP patients showed worse gait parameters than newly diagnosed PD comparators, including reduced velocity and cadence, shorter step and cycle length, and a longer cycle duration.

“Our findings indicate that gait analysis could be … a reliable biomarker in both clinical and research setting,” the researchers said. “In addition, our results may offer speculative clues for conceiving early disease-specific rehabilitation strategies.”