Coordination Rigidity in the Gait, Posture, and Speech of Persons with Parkinson's Disease.

Abstract

Parkinson's disease (PD) is associated with reduced coordination abilities. These can result either in random or rigid patterns of movement. The latter, described here as coordination rigidity (CR), have been studied less often. We explored whether CR was present in gait, quiet stance, and speech-tasks involving coordination among multiple joints and muscles. Kinematic and voice recordings were used to compute measures describing the dynamics of systems with multiple degrees of freedom and nonlinear interactions. After clinical evaluation, patients with moderate stage PD were compared against matched healthy participants. In the PD group, gait dynamics was associated with decreased dynamic divergence-lower instability-in the vertical axis. Postural fluctuations were associated with increased regularity in the anterior-posterior axis, and voice dynamics with increased predictability, all consistent with CR. The clinical relevance of CR was confirmed by showing that some of those features contribute to disease classification with supervised machine learning (82/81/85% accuracy/sensitivity/specificity).