Gait difficulties and falls are commonly reported in people with Parkinson disease (PD). Reduction in gait speed is a major characteristic of Parkinsonian gait, yet little is known about its underlying determinants, its ability to reflect an internal reservation about walking, or its relationship to falls. To study these issues, we selected age, disease severity, and nonmotor factors (i.e., depression, quality of life, balance confidence, and exercise beliefs and attitudes) to predict self-selected (SELF), fast-as-possible (FAST), and the difference (DIFF) between these walking speeds in 78 individuals with PD. We also examined gender differences in gait speeds and evaluated how gait speeds were related to a retrospective fall report. Age, disease severity, and balance confidence were strong predictors of SELF, FAST, and, to a lesser extent, DIFF. All three parameters were strongly associated with falling. DIFF was significantly greater in men compared to women and was significantly associated with male but not female fallers. The results supported the clinical utility of using a suite of gait speed parameters to provide insight into the gait difficulties and differentiating between fallers in people with PD. 1. Introduction Gait difficulties are one of the first problems reported in people with PD, indicating the onset of disability [1]. Parkinsonian gait is often slow and characterized by short shuffling steps, which may contribute to postural instability. As such, problems with walking are often accompanied by falling, which occurs in 40–70% of people with PD [2]. Fallers have higher incidences of skeletal fracture, social isolation, and reduction in exercise [3]. These consequences of a fall can in turn contribute to declines in gait and balance and lead to an additional increased risk of falling. Understanding these difficulties and developing criteria to identify people with PD who are at risk for falling are crucial to interrupt this devastating cycle of falls and injuries. Complex gait analyses use 3-dimensional kinematics to quantify the biomechanical and rhythmic impairments of gait in people with PD [4, 5]. These evaluations require sophisticated equipment and require higher level analysis. Within clinical settings, therapists currently use objective balance rating scales to measure gait and balance because they assess a wide range of postural and balance characteristics, are highly reproducible and predictive of falls [6]. However, clinical balance scales require trained raters and can be time consuming. As an alternative to the above
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