Quantitative gait analysis in patients with vascular parkinsonism

Until now the clinical criteria for the diagnosis of vascular parkinsonism (VP) have been disputed. The purpose of the present study is to investigate whether quantitative gait analysis can differentiate between the gait pattern of patients with VP and the gait pattern of patients with idiopathic Parkinson's disease (PD). Twelve patients with VP, 12 patients with PD, and 10 neurologically nondiseased controls were examined by quantitative gait analysis. Patients with VP, having a similar gait velocity and stride length, showed relatively preserved arm swing with markedly more anteflexion in the shoulder on the forward sway of the arm swing than patients with PD. Patients with VP also showed less flexion dystonic posture of the elbow, hip, knee, and trunk than did patients with PD. There was no significant difference in the excursions and coordination of arm swing in the patients with VP compared with the control group. Both patient groups showed reduced leg movements, reduced hip extension, and reduced knee flexion and extension as compared with the controls.

[1]  J. Reuck,et al.  Parkinsonism in patients with cerebral infarcts , 1980, Clinical Neurology and Neurosurgery.

[2]  J. Jankovic Parkinsonism‐plus syndromes , 1989, Movement disorders : official journal of the Movement Disorder Society.

[3]  Philip E. Martin,et al.  Characteristic Patterns of Gait in the Healthy Old , 1988, Annals of the New York Academy of Sciences.

[4]  P. M. Fitzgerald,et al.  Lower body parkinsonism: Evidence for vascular etiology , 1989, Movement disorders : official journal of the Movement Disorder Society.

[5]  E. Tolosa,et al.  Parkinsonism and basal ganglia infarcts , 1984, Neurology.

[6]  J Quintern,et al.  Electrophysiological studies of gait in spasticity and rigidity. Evidence that altered mechanical properties of muscle contribute to hypertonia. , 1981, Brain : a journal of neurology.

[7]  N. Quinn,et al.  Multiple system atrophy--the nature of the beast. , 1989, Journal of neurology, neurosurgery, and psychiatry.

[8]  M. A. van 't Hof,et al.  MRI in patients with suspected vascular parkinsonism , 1995, Neurology.

[9]  M. A. van 't Hof,et al.  Which risk factors predict the levodopa response in fluctuating Parkinson's disease? , 1990, Annals of neurology.

[10]  R. Burke,et al.  A case of parkinsonism following striatal lacunar infarction. , 1986, Journal of neurology, neurosurgery, and psychiatry.

[11]  C. Marsden,et al.  Human walking and higher‐level gait disorders, particularly in the elderly , 1993, Neurology.

[12]  J. Hughes,et al.  Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[13]  V. Hachinski,et al.  Cognitive and neurologic findings in subjects with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). , 1987, Archives of neurology.

[14]  E Knutsson,et al.  An analysis of Parkinsonian gait. , 1972, Brain : a journal of neurology.

[15]  U. Nayak,et al.  The effect of age on variability in gait. , 1984, Journal of gerontology.

[16]  M. Ronthal,et al.  Gait disorders among elderly patients. A survey study of 50 patients. , 1983, Archives of neurology.

[17]  O. Blin,et al.  Quantitative analysis of gait in Parkinson patients: increased variability of stride length , 1990, Journal of the Neurological Sciences.

[18]  J. E. Rees,et al.  Parkinson's disease, cerebral arteriosclerosis, and senile dementia. Clinical features and response to levodopa. , 1974, The Quarterly journal of medicine.

[19]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[20]  C D Marsden,et al.  Gait disorder of subcortical arteriosclerotic encephalopathy: Binswanger's disease , 1987, Movement disorders : official journal of the Movement Disorder Society.

[21]  Yasuo Nishihara,et al.  Why do frontal lobe symptoms predominate in vascular dementia with lacunes? , 1986, Neurology.

[22]  J. Friedman Advances in neurology, volume 49 (facial dyskinesias). Joseph Jankovic, Edwardo Tolosca, (eds), Raven press, New York, $102.00. 1988 , 1989 .

[23]  J. M. Sutherland,et al.  Arteriosclerosis in Parkinsonism , 1964, Journal of neurology, neurosurgery, and psychiatry.

[24]  M. P. Murray,et al.  Walking patterns in healthy old men. , 1969, Journal of gerontology.