The validity of the Gait Variability Index for individuals with mild to moderate Parkinson's disease

Abstract

Increased step-to-step variability is a feature of gait in individuals with Parkinson’s disease (PD) and is associated with increased disease severity and reductions in balance and mobility. The Gait Variability Index (GVI) quantifies gait variability in spatiotemporal variables where a score ≥100 indicates a similar level of gait variability as the control group, and lower scores denote increased gait variability. The study aim was to explore mean GVI score and investigate construct validity of the index for individuals with mild to moderate PD. 100 (57 males) subjects with idiopathic PD, Hoehn & Yahr 2 (n = 44) and 3, and ≥60 years were included. Data on disease severity, dynamic balance, mobility and spatiotemporal gait parameters at self-selected speed (GAITRite) was collected. The results showed a mean overall GVI: 97.5 (SD 11.7) and mean GVI for the most affected side: 94.5 (SD 10.6). The associations between the GVI and Mini- BESTest and TUG were low (r = 0.33 and 0.42) and the GVI could not distinguish between Hoehn & Yahr 2 and 3 (AUC = 0.529, SE = 0.058, p = 0.622). The mean GVI was similar to previously reported values for older adults, contrary to consistent reports of increased gait variability in PD compared to healthy peers. Therefore, the validity of the GVI could not be confirmed for individuals with mild to moderate PD in its current form due to low associations with validated tests for functional balance and mobility and poor discriminatory ability. Future work should aim to establish which spatiotemporal variables are most informative regarding gait variability in individuals with PD.