Background: Gait disturbance accompanies many neurodegenerative diseases; it is characteristic for Parkinson's disease (PD). Treatment of advanced PD often includes deep brain stimulation (DBS) of the subthalamic nucleus. Regarding gait, previous studies have reported non-significant or conflicting results, possibly related to methodological limitations. Objective: The objective of this prospective study was to assess the effects of DBS on biomechanical parameters of gait in patients with PD. Methods: Twenty-one patients with advanced PD participated in this prospective study. Gait was examined in all patients using the Zebris FDM-T pressure-sensitive treadmill (Isny, Germany) before DBS implantation and after surgery immediately, further immediately after the start of neurostimulation, and 3 months after neurostimulator activation. We assessed spontaneous gait on a moving treadmill at different speeds. Step length, stance phase of both lower limbs, double-stance phase, and cadence were evaluated. Results: In this study, step length increased, allowing the cadence to decrease. Double-stance phase duration, that is, the most sensitive parameter of gait quality and unsteadiness, was reduced, in gait at a speed of 4.5 km/h and in the narrow-based gaits at 1 km/h (tandem gait), which demonstrates improvement. Conclusion: This study suggests positive effects of DBS treatment on gait in PD patients. Improvement was observed in several biomechanical parameters of gait.

Department of Neurology University Hospital and Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czechia

Department of Neurosurgery University Hospital and Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czechia

Department of Rehabilitation University Hospital and Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czechia

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$a Navratilova, Daniela $u Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Deep Brain Stimulation Effects on Gait Pattern in Advanced Parkinson's Disease Patients / $c D. Navratilova, A. Krobot, P. Otruba, M. Nevrly, D. Krahulik, P. Kolar, B. Kolarova, M. Kaiserova, K. Mensikova, M. Vastik, S. Kurcova, P. Kanovsky,

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$a Background: Gait disturbance accompanies many neurodegenerative diseases; it is characteristic for Parkinson's disease (PD). Treatment of advanced PD often includes deep brain stimulation (DBS) of the subthalamic nucleus. Regarding gait, previous studies have reported non-significant or conflicting results, possibly related to methodological limitations. Objective: The objective of this prospective study was to assess the effects of DBS on biomechanical parameters of gait in patients with PD. Methods: Twenty-one patients with advanced PD participated in this prospective study. Gait was examined in all patients using the Zebris FDM-T pressure-sensitive treadmill (Isny, Germany) before DBS implantation and after surgery immediately, further immediately after the start of neurostimulation, and 3 months after neurostimulator activation. We assessed spontaneous gait on a moving treadmill at different speeds. Step length, stance phase of both lower limbs, double-stance phase, and cadence were evaluated. Results: In this study, step length increased, allowing the cadence to decrease. Double-stance phase duration, that is, the most sensitive parameter of gait quality and unsteadiness, was reduced, in gait at a speed of 4.5 km/h and in the narrow-based gaits at 1 km/h (tandem gait), which demonstrates improvement. Conclusion: This study suggests positive effects of DBS treatment on gait in PD patients. Improvement was observed in several biomechanical parameters of gait.

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$a Krobot, Alois $u Department of Rehabilitation, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Otruba, Pavel $u Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Nevrly, Martin $u Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Krahulik, David $u Department of Neurosurgery, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Kolar, Petr $u Department of Rehabilitation, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Kolarova, Barbora $u Department of Rehabilitation, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Kaiserova, Michaela $u Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Mensikova, Katerina $u Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Vastik, Miroslav $u Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Kurcova, Sandra $u Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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$a Kanovsky, Petr $u Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.

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