NORDIC WALKING CAN IMPROVE DYNAMIC STABILITY OF HUMAN GAIT IN PARKINSON’S DISEASE

Introduction: Activating the upper body during walking, Nordic walking (NW) may be used as an external cueing to improve spatiotemporal parameters of gait, such as stride length or gait variability, in Parkinson disease (PD). Structured gait variability, revealed by the presence of long-range autocorrelations (LRA), was associated to dynamic stability of gait. Dynamic stability has been de ned as the ability to maintain functional locomotion despite the presence of internal or external disturbances, which is a feature of healthy locomotor system. Purpose: To assess bene cial e ects of NW on dynamic stability of gait and spatiotemporal gait parameters in PD. Methods: Fourteen mild to moderate PD patients performed 2×12min overground walking sessions (with and without pole in a randomized order) at a comfortable speed. Gait speed, cadence, step length and tem- poral organization (i.e. LRA) of stride duration variability were studied on 512 consecutive gait cycles using a unidimensional accelerometer placed on the malleola of the most a ected side. e presence of LRA was determined using the Rescaled Range Analysis (Hurst exponent) and the power spectral density (á exponent). To assess NW in uence on PD gait, a paired t-test was used. Results: All patients presented LRA during both walking sessions. However, Hurst and á exponents were sig- ni cantly higher during NW (p<0,001). While gait speed remained unchanged between two walking sessions, gait cadence decreased (p=0,009) and step length increased signi cantly (p=0,003). Discussion and conclusions: is study demonstrates that Nordic walking can improve the dynamic stabil- ity of gait in PD. Involving a voluntary intersegmental coordination, such improvement could also be due to the upper body rhythmic movements acting as rhythmical external cue to bypass their defective basal ganglia circuitries. erefore, Nordic walking may constitute a powerful way to manage gait disorders in PD.