In people with Parkinson's disease, gait coordination deficits localise primarily to the core body segments and are accompanied by a reduced ability to modulate whole-body coordination with walking speed.
Key Findings
Results
People with Parkinson's disease showed coherence deficits during walking compared to healthy controls, particularly at preferred walking speed and in the anteroposterior direction.
Twenty-nine people with Parkinson's disease (PwPD) and 29 healthy controls participated in the study.
Participants walked forward along a straight walking path at three walking speeds.
Coherence deficits were most pronounced at preferred speed rather than slow or fast speeds.
Deficits were particularly evident in the anteroposterior movement direction.
Kinectomes were built by computing pairwise correlations between body segment accelerations to quantify coherence.
Results
Coordination deficits in Parkinson's disease primarily affected core body segments rather than distal limb segments.
Nodal strength, defined as coherence between a body segment and all other body segments, was the primary metric used to assess segmental contribution.
Core body segments showed the greatest reductions in nodal strength in PwPD compared to controls.
Network graphs were generated with anatomical segments as nodes and their co-accelerations as edges.
Graph-theoretic analysis examined community organisation, modularity metrics, and network topology to localise deficits.
Results
Healthy controls demonstrated speed-dependent modulation of whole-body gait coherence that was absent in people with Parkinson's disease.
Controls showed speed-dependent modulation of coherence, meaning their inter-segmental coordination changed systematically across the three walking speeds.
This speed-dependent modulation was absent in PwPD, particularly in the anteroposterior direction.
The lack of speed modulation was most evident within core body segments.
Three walking speeds were tested: slow, preferred, and fast.
Results
People with Parkinson's disease showed speed-dependent modulation of coherence primarily in lower limb segments across the mediolateral and vertical directions.
Unlike controls whose speed modulation was in core segments and the anteroposterior direction, PwPD modulated coherence in lower limb segments.
This modulation in PwPD occurred primarily in the mediolateral and vertical movement directions.
This pattern suggests a compensatory or altered coordination strategy in PwPD when changing walking speed.
The finding highlights directional specificity of coordination differences between PwPD and controls.
Methods
A graph-theoretical kinectome framework was used to enable individualised identification of segmental coordination deficits in Parkinson's disease.
Kinectomes were constructed from pairwise correlations between accelerations of body segments at each walking speed and movement direction.
Community organisation and modularity metrics were extracted in addition to nodal strength.
The framework allows identification of which specific body segments show coordination deficits in individual patients.
The authors propose this enables tailored treatment planning based on individual segmental coordination profiles.
The study was registered in the German Clinical Trials Register (DRKS00022998, registered 04 Sep 2020).
Discussion
The authors suggest trunk-focused and progressive speed-variable gait training may be a particularly effective rehabilitation strategy for Parkinson's disease based on the pattern of deficits identified.
This recommendation is based on the finding that coordination deficits localise primarily to core body segments.
The reduced ability to modulate whole-body coordination with walking speed further supports speed-variable training approaches.
The suggestion applies specifically to anteroposterior coordination in core body segments.
This was framed as a clinical implication rather than a tested intervention in this study.
What This Means
This research suggests that when people with Parkinson's disease walk, the way different parts of their body move together in a coordinated fashion is disrupted compared to healthy adults. Using wearable sensors and a network-based mathematical analysis, the researchers mapped how well each body segment's movements were synchronized with all other segments during walking at three different speeds. They found that the biggest coordination problems in Parkinson's disease were concentrated in the core or trunk of the body — the central segments like the torso and pelvis — rather than in the arms or legs, and these problems were most apparent when walking at a comfortable, self-chosen speed.
The research also found that healthy people naturally adjust how their body segments work together when they walk faster or slower, but people with Parkinson's disease largely lose this ability to adapt coordination with speed, particularly in the forward-backward (anteroposterior) direction in their core segments. Instead, people with Parkinson's disease showed some speed-related changes in their leg movements in the side-to-side and up-down directions, suggesting a different and potentially compensatory movement pattern.
This research suggests that rehabilitation programs for Parkinson's disease might be most effective if they specifically target trunk coordination and include practice walking at a range of different speeds, rather than focusing only on leg movements. The mathematical framework used in this study also has potential for identifying each individual patient's specific coordination weaknesses, which could allow for more personalized physical therapy planning.
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Saegner K, Conceição P, Romijnders R, Welzel J, Vuillerme N, Hansen C, et al.. (2026). Whole body analysis of functional communities and topological features of gait with different speeds in Parkinson's disease.. Journal of neurology. https://doi.org/10.1007/s00415-026-13920-z