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Due to the imposed constant belt speed, motorized treadmills are known to affect linear and nonlinear gait variability outcomes. This is particularly true of patients with Parkinson’s Disease where the treadmill can act as an external pacemaker. Self-paced treadmills update the belt speed in response to the subject's walking speed and might, therefore, be a useful tool for measurement of gait variability in this patient population. This study aimed to compare gait variability during walking at self-paced and constant treadmill speeds with overground walking in individuals with PD and individuals with unimpaired gait.


Thirteen patients with Parkinson’s Disease and thirteen healthy controls walked under three conditions: overground, on a treadmill at a constant speed, and using three self-paced treadmill modes. Gait variability was assessed with coefficient of variation (CV), sample entropy (SampEn), and detrended fluctuation analysis (DFA) of stride time and length. Systematic and random error between the conditions was quantified.


For individuals with PD, error in variability measurement was less during self-paced modes compared with constant treadmill speed for stride time but not for stride length. However, there was substantial error for stride time and length variability for all treadmill conditions. For healthy controls the error in measurement associated with treadmill walking was substantially less.


The large systematic and random errors between overground and treadmill walking prohibit meaningful gait variability observations in patients with Parkinson’s Disease using self-paced or constant-speed treadmills.


NOTICE: this is the author’s version of a work that was accepted for publication in Gait & Posture. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Gait & Posture, volume 91, in 2021.

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