Jim Cavanaugh co-authors publication on walking performance in individuals with Parkinson’s disease

Jim Cavanaugh, PT, Ph.D., professor in the Department of Physical Therapy, is a co-author on a new publication entitled “Does clinically measured walking capacity contribute to real-world walking performance in people with Parkinson’s disease?”

The work represents a baseline data analysis conducted as part of a five-year, dual-site, National Institutes of Health (NIH)-funded clinical trial (“Walking and mHealth to Increase Participation in Parkinson Disease”), on which Cavanaugh is a co-investigator.

According to the researchers, walking limitations are one of the most disabling features of Parkinson’s disease (PD) and a primary reason for seeking rehabilitation services. Studies have shown that, even in early disease progression, those with PD demonstrate a 12% reduction in daily steps and 40% reduction in daily moderate intensity walking minutes over one year when compared to their non-PD older adult counterparts.

“Such decline is particularly concerning given that walking at higher intensities may produce substantial health benefits and have disease-modifying effects,” the researchers assert. “Moreover, PD interventions incorporating real-world walking practice show promise for improving function, reducing disability, and slowing the expected natural decline in daily walking activity.”

According to Cavanaugh, when developing walking exercise programs for their patients with PD, physical therapists rely on clinical measures of walking capacity to make inferences about real-world walking behavior. He said the validity of such inferences, however, is not clear.

To better understand the issue, the purpose of the study was to determine the contribution of clinically measured walking capacity in persons with PD to their walking performance at home and in the community.

For the study, participants with mild to moderate idiopathic PD were assessed using two tests of walking capacity — the 6-minute walk test (6MWT), a measure of walking distance over a period of six minutes, and the 10-meter walk test (10MWT), a measure of gait speed. Participants’ real-world walking performance over the course of one week was assessed using a small device that measured the amount and intensity of their walking.

Ultimately, the researchers found that walking capacity contributed to, but explained a relatively small portion of the variance in, real-world walking performance, and that the contribution was somewhat greater in less active individuals.

“The study adds support to the idea that clinically measured walking capacity may have limited benefit for understanding real-world walking performance in PD,” they concluded. “Factors beyond walking capacity may better account for actual walking behavior.”