Arm-swing kinematics in Parkinson's disease: A systematic review and meta-analysis.

Abstract

Background: Parkinson’s disease (PD) causes postural instability and gait abnormalities that may be associated with an arm swing reduction. Objective: To conduct systematic review and meta-analysis to determine the kinematic patterns of arm-swing during gait in people with PD Methods: A computer literature search of the PubMed, EMBASE, WOS, PEDro, SCOPUS and SciELO databases was conducted. Terms related to PD and arm-swing were combined to find studies that performed a free walking evaluation of the arm-swing of PD patients on or off medication compared to healthy controls. After a standardized evaluation by three examiners, fifteen articles met inclusion criteria. Random effects meta-analysis models were utilized to quantify (1) the arm-swing range of motion (RoM); (2) the arm-swing amplitude; (3) the arm-swing velocity; and (4) the arm-swing asymmetry. Results: On average, arm-swing RoM (7.07◦), amplitude (0.8 cm), and velocity (0.31 m/s) were significantly decreased in PD compared to healthy controls. Healthy subjects had significantly more symmetrical arm-swing (8.16%) than people with PD. Effect sizes were moderate-large. Conclusions: People with PD have significant differences in RoM, amplitude, velocity, and asymmetry of armswing during gait compared to the healthy control group. Medication phase does not significantly influence arm-swing characteristics. Further studies will be needed to determine whether different disease characteristics influence the biomechanics of arm-swing during gait.