Gait Variability as a Potential Motor Marker of Cerebellar Disease—Relationship between Variability of Stride, Arm Swing and Trunk Movements, and Walking Speed
Daniel Kroneberg,
Astrid Nümann,
Martina Minnerop,
Maria Rönnefarth,
Matthias Endres,
Andrea A. Kühn,
Friedemann Paul,
Sarah Doss,
Susanne Solbrig,
Morad Elshehabi,
Walter Maetzler,
Tanja Schmitz-Hübsch
Affiliations
Daniel Kroneberg
Department of Neurology with Experimental Neurology, Charité–Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
Astrid Nümann
Department of Neurology with Experimental Neurology, Charité–Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
Martina Minnerop
Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, 52425 Jülich, Germany
Maria Rönnefarth
Department of Neurology with Experimental Neurology, Charité–Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
Matthias Endres
Department of Neurology with Experimental Neurology, Charité–Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
Andrea A. Kühn
Department of Neurology with Experimental Neurology, Charité–Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
Friedemann Paul
Department of Neurology with Experimental Neurology, Charité–Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
Sarah Doss
Department of Neurology with Experimental Neurology, Charité–Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
Susanne Solbrig
Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany
Morad Elshehabi
Department of Neurology, Universitätsklinikum Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany
Walter Maetzler
Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany
Tanja Schmitz-Hübsch
Experimental and Clinical Research Center, a cooperation of Max-Delbrueck Center of Molecular Medicine and Charité–Universitätsmedizin Berlin, Lindenberger Weg 80, 13125 Berlin, Germany
Excessive stride variability is a characteristic feature of cerebellar ataxias, even in pre-ataxic or prodromal disease stages. This study explores the relation of variability of arm swing and trunk deflection in relationship to stride length and gait speed in previously described cohorts of cerebellar disease and healthy elderly: we examined 10 patients with spinocerebellar ataxia type 14 (SCA), 12 patients with essential tremor (ET), and 67 healthy elderly (HE). Using inertial sensors, recordings of gait performance were conducted at different subjective walking speeds to delineate gait parameters and respective coefficients of variability (CoV). Comparisons across cohorts and walking speed categories revealed slower stride velocities in SCA and ET patients compared to HE, which was paralleled by reduced arm swing range of motion (RoM), peak velocity, and increased CoV of stride length, while no group differences were found for trunk deflections and their variability. Larger arm swing RoM, peak velocity, and stride length were predicted by higher gait velocity in all cohorts. Lower gait velocity predicted higher CoV values of trunk sagittal and horizontal deflections, as well as arm swing and stride length in ET and SCA patients, but not in HE. These findings highlight the role of arm movements in ataxic gait and the impact of gait velocity on variability, which are essential for defining disease manifestation and disease-related changes in longitudinal observations.
