We take walking for granted until something happens and we’re not so mobile anymore. Babies teach themselves to walk and it’s a miracle. Then you age and maybe get Parkinson’s, and suddenly walking is a distraction, an issue, maybe even impossible.
When my meds are “on” I walk for blocks on the streets of Manhattan at a brisk, even pace, just like everyone else. It’s practically mandatory to walk fast if you live in New York City. But before my meds kick in in the morning, I shuffle around the bedroom and kitchen with a festinating gait, and if my meds wear off during the day, I start to drag my right leg and walk with stooped-over posture.
How I live my life in the world, and how I live the 30-minute, four-times-a-year appointments with my neurologist, are two different things. I’m always “on” when I see her, so when she watches me walk in the hallway outside her office door, I’m rather OK.
A recent research article (“Patient-reported and performance-based measures of walking in mild-moderate Parkinson’s disease”) describes a project that tried to connect what Parkinson’s patients say about their day-to-day walking experiences, and what doctors, researchers and other clinicians see when they examine a Parkie.
How did the researchers do this? They compared data on 47 people without PD and 49 people with PD (Hoehn and Yahr stages II and III). The data set included:
- Patient-reported walking difficulties, which were based on a 12-item questionnaire (the “Walk-12G”) that was so easy to understand that the participants could fill it out on their own. (View it below and try it yourself!)
- Patient performance on walking tests in research labs using an electronic walkway, which supplied this information on the walker’s gait: pace, rhythm, asymmetry, variability and postural control.
- Information gathered by devices that the patients wore in free-living conditions, which recorded mean steps/day and minutes of brisk walking/day.
What was the outcome? I think the researchers were hoping for a strong correlation between the self-reported questionnaire and the other two sets of data, but this didn’t happen. The standout results were as follows:
“The main finding of this study was that perceived walking difficulties in daily life appear to be most strongly associated with Step velocity – a laboratory-assessed performance measure, and steps per day – a measure of walking behavior in free living among people with mild to moderate PD. Additionally, subgroup comparisons showed that the Walk-12G has moderate ability to distinguish between mild-moderate PD stages and excellent ability to distinguish between people with and without the disease. These findings further support the clinical utility of the Walk-12G in people with mild to moderate PD.”
Elsewhere, the researchers note “We observed no correlation between perceived walking difficulties and aspects of gait Rhythm, Asymmetry, or Postural Control.”
Thus, the researchers suggest that the Walk-12G questionnaire be used in conjunction with clinical procedures, as it provides a bridge between what the Parkie believes he/she is experiencing, and what the clinician wants to focus on to improve the Parkie’s well-being.
The authors conclude:
“The Walk-12G is an easily administered questionnaire which can be quick to apply in the clinical context to capture patient perspectives, for example, in the initial screening of walking among people with PD, prior to therapy. By focusing specifically on walking situations, Walk-12G scores provide the opportunity for healthcare professionals to plan task-specific training in line with patients’ needs.”
A jumping-off place, if you will.
I’ve pasted the Walk-12G below; you may need to enlarge it to see it clearly. And below that, Patsy Cline serenades us with her hit, “Walking After Midnight.”
Walk on!
