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Circular walking is useful for assessing the risk of falls in early progressive supranuclear palsy

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Abstract

Background

Progressive supranuclear palsy (PSP) is characterized by early onset postural instability and frequent falls. Circular walking necessitates dynamic postural control, which is impaired in patients with PSP. We aimed to explore gait parameters associated with the risk of falls in patients with PSP, focusing on circular walking.

Methods

Sixteen drug-naïve patients with PSP, 22 drug-naïve patients with Parkinson’s disease (PD), and 23 healthy controls were enrolled. Stride lengths/velocities and their coefficients of variation (CV) during straight and circular walking (walking around a circle of 1-m diameter) were measured under single-task and cognitive dual-task conditions. Correlation analysis was performed between gait parameters and postural instability and gait difficulty (PIGD) motor subscores, representing the risk of falls.

Results

Patients with PSP had significantly higher CVs of stride lengths/velocities during circular walking than those during straight walking, and the extent of exacerbation of CVs in patients with PSP was larger than that in patients with PD under single-task conditions. Stride lengths/velocities and their CVs were significantly correlated with PIGD motor subscores in patients with PSP only during single-task circular walking. In addition, patients with PSP showed progressive decrements of stride lengths/velocities over steps only during single-task circular walking.

Conclusions

Worse gait parameters during circular walking are associated with an increased risk of falls in patients with PSP. Circular walking is a challenging task to demand the compromised motor functions of patients with PSP, unmasking impaired postural control and manifesting sequence effect. Assessing circular walking is useful for evaluating the risk of falls in patients with early PSP.

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Acknowledgements

The authors thank the clinical staff in our hospitals for taking care of patients.

Funding

This research was supported by the Nakayama Foundation for Human Science.

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Authors and Affiliations

  1. Department of Neurology and Neurological Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Masahiro Ohara, Kosei Hirata, Taiki Matsubayashi, Qingmeng Chen, Kaoru Shimano, Takanori Yokota & Takaaki Hattori

  2. Department of Clinical Biostatistics, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan

    Ryoichi Hanazawa & Akihiro Hirakawa

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  1. Masahiro Ohara
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Contributions

M.O. designed the study, acquired, and analyzed the data, and wrote the draft. K.H. designed the study, acquired the data, and revised the manuscript. T.M., Q.C., and K.S. acquired the data and revised the manuscript. R.H. and A.H. contributed to the statistical analysis of the manuscript and revised the manuscript. T.H. contributed to the analysis of data, the conception and design of the study, and revised and finalized the manuscript.

Corresponding author

Correspondence to Takaaki Hattori.

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Conflicts of interest

Dr. Ohara declares no conflict of interest associated with this manuscript. Dr. Hirata declares no conflict of interest associated with this manuscript. Dr. Matsubayashi declares no conflict of interest associated with this manuscript. Dr. Chen declares no conflict of interest associated with this manuscript. Dr. Shimano declares no conflict of interest associated with this manuscript. Dr. Hanazawa declares no conflict of interest associated with this manuscript. Dr. Hirakawa declares no conflict of interest associated with this manuscript. Dr. Yokota declares no conflict of interest associated with this manuscript. Dr. Hattori has received speaker’s honoraria from Daiichi Sankyo Company, Limited; Sumitomo Dainippon Pharma Co., Ltd.; Integra Japan Co., Ltd and Kyowa Kirin Co., Ltd.

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Ohara, M., Hirata, K., Matsubayashi, T. et al. Circular walking is useful for assessing the risk of falls in early progressive supranuclear palsy. J Neurol (2024). https://doi.org/10.1007/s00415-024-12551-6

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