A NEW CLINICAL TOOL FOR GAIT EVALUATION IN PARKINSONS-DISEASE

This study was devised to check the feasibility and validity of a rati ng scale specifically designed to evaluate gait impairment in Parkinso n's disease (RSGE). Demographic data, a brief questionnaire on general aspects influencing gait and mobility, a battery of scales (Barthel I ndex; Hoehn and Yahr staging; and Northwestern University Disability, Schwab and England, and Unified Parkinson's Disease Rating Scale [UPDR S]), and timed tests (''Up and Go'' and ''Steps x Seconds'' tests) wer e recorded under protocol, as was the RSGE-Version 1.0 (23 items in fo ur subscales). Fifty patients enrolled at two centers were included. T wenty-five (50%) were simultaneously (though independently) evaluated by three examiners, in order to determine the interrater reliability, The mean age of the patients was 67.6 +/- 11.16 years, with a mean 8.1 8 +/- 5.58 years of disease duration. Motor fluctuations were present in 48% of patients. The RSGE Cronbach's alpha was 0.94. Only the item ''Dyskinesias'' was not correlated with the RSGE total sum. The item ' 'Axial rigidity'' showed a fair interrater reliability (kappa = 0.30). However, most of the RSGE items (16/23, 70%) had kappa greater than o r equal to 0.65. The convergent validity with the applied scales was v ery high (Spearman r = 0.74-0.90, p < 0.001). The highest correlation (0.90) was obtained with the UPDRS. Also, the RSGE correlation with ti med tests was very satisfactory (''Up and Go'' = 0.81; ''Steps x Secon ds'' = 0.70; both, p < 0.001), Factor analysis of the RSGE disclosed f our dimensions explaining 68% of the variance. The RSGE-Version 1.0 pr oved to be a valid instrument. The reliability of some items has to be improved, however.