Kinematic Study of Whole Body Center of Mass Position During Gait in Parkinson's Disease Patients with and Without Festination

Gait festination (FE) can cause serious disability in Parkinson's disease (PD) patients. It is argued that the center of pressure position (COP) and body center of mass (COM) are possibly implicated in FE pathogenesis. The relationship between them remains unclear. The goal of this study was to determine spatiotemporal relationships between COM and COP in PD and to explore whether FE arises as a consequence of lack of physiological link between COP and COM during step stride. Twenty patients with idiopathic PD, in OFF state and 17-age-matched control subjects completed a 10-m walking protocol. PD patients were divided in two groups: those with FE and those without (NF). COM position, excursion, and its relationship with COP, as well as other kinematic parameters were analyzed. COM displacement along the horizontal and vertical plane was significantly lower in FE patients as was the maximum position on the movement direction axis compared with controls or NF patients. Significant difference in minimal COM position in FE patients was also observed. The percentage of stride time during which COM was situated ahead of COP along the movement axis in FE patients was significantly greater than for controls or NF patients. This would seem to indicate that FE patients are constantly attempting to align COP to COM, causing FE. The explanation might be that FE arises as a postural strategy to align COP within the area of COM displacement. Findings illustrate a putative role for postural strategies in the treatment of FE. © 2010 Movement Disorder Society