Differential diagnosis of parkinsonism with visual inspection of posture and gait in the early stage

Seon Min Lee; Minjik Kim; Hye Mi Lee; Kyum Yil Kwon; Hee Tae Kim; Seong Beom Koh

doi:10.1016/j.gaitpost.2014.01.004

Differential diagnosis of parkinsonism with visual inspection of posture and gait in the early stage

Seon Min Lee, Minjik Kim, Hye Mi Lee, Kyum Yil Kwon, Hee Tae Kim, Seong Beom Koh

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Background: Parkinson's disease (PD) differs from atypical parkinsonism in many clinical aspects. Principally, posture and gait are distinct features in the early stages of the disease; thus, these differences can be helpful in differential diagnosis. Methods: We analyzed videos of patients with PD or atypical parkinsonism. A total of 76 patients with early PD (n= 56) or atypical parkinsonism (n= 20) were included. Items related to posture and gait were classified into three categories (standing, gait and associated symptoms) and each sub-item was analyzed. Results: Asymmetric arm-swing (p= 0.004) and accompanying tremor (p= 0.016) were significant indicators of early-stage PD. Staggering gait (p= 0.007) and en-bloc turning (p= 0.026) were more common in atypical parkinsonism. Characteristics with a high odds-ratio for atypical parkinsonism were en-bloc turning (β= 8.475, p= 0.032) and normal arm-swing (β= 14.6084, p= 0.036). Conclusions: Visual inspection of gait and posture provides reliable clues in the differential diagnosis of parkinsonism.

Original language	English
Pages (from-to)	1138-1141
Number of pages	4
Journal	Gait and Posture
Volume	39
Issue number	4
DOIs	https://doi.org/10.1016/j.gaitpost.2014.01.004
Publication status	Published - 2014 Apr

Bibliographical note

Funding Information:
Fifty-six PD patients and 20 AP patients were included in this study. All patients were clinically diagnosed with PD or AP at Korea University Guro Hospital. Motor scores, including gait and posture, had been previously recorded with a camcorder. We included patients who were within five years of initial symptom presentation, had a Hoeh and Yahr (H&Y) stage < 3, and were able to stand and walk without assistance. Clinical diagnosis was based on criteria set by the National Institute of Neurological Disorders and Stroke and the Society for Progressive Supranuclear Palsy (NINDS–SPSP) for progressive supranuclear palsy (PSP), the Multiple Systemic Atrophy (MSA) Consensus criteria for MSA, and the United Kingdom PD Society Brain Bank criteria for PD [2–4] . The study protocol was approved by the relevant institutional review board and all subjects provided written informed consent. 2.2

Keywords

Arm-swing
Atypical parkinsonism
Early stage
Parkinson's disease

ASJC Scopus subject areas

Biophysics
Orthopedics and Sports Medicine
Rehabilitation

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10.1016/j.gaitpost.2014.01.004

Cite this

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title = "Differential diagnosis of parkinsonism with visual inspection of posture and gait in the early stage",

abstract = "Background: Parkinson's disease (PD) differs from atypical parkinsonism in many clinical aspects. Principally, posture and gait are distinct features in the early stages of the disease; thus, these differences can be helpful in differential diagnosis. Methods: We analyzed videos of patients with PD or atypical parkinsonism. A total of 76 patients with early PD (n= 56) or atypical parkinsonism (n= 20) were included. Items related to posture and gait were classified into three categories (standing, gait and associated symptoms) and each sub-item was analyzed. Results: Asymmetric arm-swing (p= 0.004) and accompanying tremor (p= 0.016) were significant indicators of early-stage PD. Staggering gait (p= 0.007) and en-bloc turning (p= 0.026) were more common in atypical parkinsonism. Characteristics with a high odds-ratio for atypical parkinsonism were en-bloc turning (β= 8.475, p= 0.032) and normal arm-swing (β= 14.6084, p= 0.036). Conclusions: Visual inspection of gait and posture provides reliable clues in the differential diagnosis of parkinsonism.",

keywords = "Arm-swing, Atypical parkinsonism, Early stage, Parkinson's disease",

author = "Lee, {Seon Min} and Minjik Kim and Lee, {Hye Mi} and Kwon, {Kyum Yil} and Kim, {Hee Tae} and Koh, {Seong Beom}",

note = "Funding Information: Fifty-six PD patients and 20 AP patients were included in this study. All patients were clinically diagnosed with PD or AP at Korea University Guro Hospital. Motor scores, including gait and posture, had been previously recorded with a camcorder. We included patients who were within five years of initial symptom presentation, had a Hoeh and Yahr (H&Y) stage < 3, and were able to stand and walk without assistance. Clinical diagnosis was based on criteria set by the National Institute of Neurological Disorders and Stroke and the Society for Progressive Supranuclear Palsy (NINDS–SPSP) for progressive supranuclear palsy (PSP), the Multiple Systemic Atrophy (MSA) Consensus criteria for MSA, and the United Kingdom PD Society Brain Bank criteria for PD [2–4] . The study protocol was approved by the relevant institutional review board and all subjects provided written informed consent. 2.2 ",

year = "2014",

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doi = "10.1016/j.gaitpost.2014.01.004",

language = "English",

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AU - Lee, Seon Min

AU - Kim, Minjik

AU - Lee, Hye Mi

AU - Kwon, Kyum Yil

AU - Kim, Hee Tae

AU - Koh, Seong Beom

N1 - Funding Information: Fifty-six PD patients and 20 AP patients were included in this study. All patients were clinically diagnosed with PD or AP at Korea University Guro Hospital. Motor scores, including gait and posture, had been previously recorded with a camcorder. We included patients who were within five years of initial symptom presentation, had a Hoeh and Yahr (H&Y) stage < 3, and were able to stand and walk without assistance. Clinical diagnosis was based on criteria set by the National Institute of Neurological Disorders and Stroke and the Society for Progressive Supranuclear Palsy (NINDS–SPSP) for progressive supranuclear palsy (PSP), the Multiple Systemic Atrophy (MSA) Consensus criteria for MSA, and the United Kingdom PD Society Brain Bank criteria for PD [2–4] . The study protocol was approved by the relevant institutional review board and all subjects provided written informed consent. 2.2

PY - 2014/4

Y1 - 2014/4

N2 - Background: Parkinson's disease (PD) differs from atypical parkinsonism in many clinical aspects. Principally, posture and gait are distinct features in the early stages of the disease; thus, these differences can be helpful in differential diagnosis. Methods: We analyzed videos of patients with PD or atypical parkinsonism. A total of 76 patients with early PD (n= 56) or atypical parkinsonism (n= 20) were included. Items related to posture and gait were classified into three categories (standing, gait and associated symptoms) and each sub-item was analyzed. Results: Asymmetric arm-swing (p= 0.004) and accompanying tremor (p= 0.016) were significant indicators of early-stage PD. Staggering gait (p= 0.007) and en-bloc turning (p= 0.026) were more common in atypical parkinsonism. Characteristics with a high odds-ratio for atypical parkinsonism were en-bloc turning (β= 8.475, p= 0.032) and normal arm-swing (β= 14.6084, p= 0.036). Conclusions: Visual inspection of gait and posture provides reliable clues in the differential diagnosis of parkinsonism.

AB - Background: Parkinson's disease (PD) differs from atypical parkinsonism in many clinical aspects. Principally, posture and gait are distinct features in the early stages of the disease; thus, these differences can be helpful in differential diagnosis. Methods: We analyzed videos of patients with PD or atypical parkinsonism. A total of 76 patients with early PD (n= 56) or atypical parkinsonism (n= 20) were included. Items related to posture and gait were classified into three categories (standing, gait and associated symptoms) and each sub-item was analyzed. Results: Asymmetric arm-swing (p= 0.004) and accompanying tremor (p= 0.016) were significant indicators of early-stage PD. Staggering gait (p= 0.007) and en-bloc turning (p= 0.026) were more common in atypical parkinsonism. Characteristics with a high odds-ratio for atypical parkinsonism were en-bloc turning (β= 8.475, p= 0.032) and normal arm-swing (β= 14.6084, p= 0.036). Conclusions: Visual inspection of gait and posture provides reliable clues in the differential diagnosis of parkinsonism.

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ER -

Differential diagnosis of parkinsonism with visual inspection of posture and gait in the early stage

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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