Heel to toe motion characteristics in Parkinson patients during free walking

Objective. Plantar pressures of Parkinson patients in a mild or moderate st age of the disease were analyzed in order to determine characteristics of t he heel to toe motion of the foot in Parkinson patients during free walking . Design. Pressure sensitive insoles were used to quantify the in-shoe pressu re distribution for 24 patients with Parkinson's disease and for 24,age-mat ched healthy, adults. Peak plantar pressures, relative loads and the variab ility of relative loads were analyzed for 10 different anatomical foot area s. Inferential statistics and regression analyses were performed to compare subject groups and to, relate pressure data to a clinical score (Webster). Background. It is well-known that Parkinson patients experience disorders o f balance, posture and gait. Recent studies revealed that Parkinson patient s show abnormalities in foot strike during walking. However, only little is known about the heel to toe motion of the foot in Parkinson patients in co mpensating for instability during walking. Results. Parkinson patients show significant changes in foot loading behavi or. Parkinson patients have a reduced impact at heel strike. This mechanism was found to be related to the severity of the disease. Furthermore, Parki nson patients show a trend towards higher relative loads in the forefoot re gions combined with a load shift towards medial foot areas. These mechanism s are highly stereotypical. Conclusion. Parkinson patients, even in a mild or moderate stage of the dis ease, show significant changes in heel to toe motion of the foot during fre e walking. The characteristics of Parkinsonian gait are probably caused by adaptive mechanisms of the patients to avoid unsteadiness during walking.