Parkinson’s Disease and Gait Asymmetry

The aim of this chapter was to deepen into the topic of gait asymmetry (GA) among individuals with Parkinson’s disease (PD). This chapter commenced by furnishing a comprehensive definition of GA, accompanied by an exploration of its manifestation and the theoretical constructs that elucidate the origins of motor asymmetry within the context of PD. The subsequent section spotlighted the principal findings concerning GA in the PD population, focusing on three pivotal domains: gait initiation, overground walking, and challenging walking (obstacle avoidance and dual-tasking). Intriguingly, although individuals with PD do not exhibit motor asymmetry during gait initiation, they do manifest cortical activity asymmetry. On the other hand, asymmetry is observed in multiple gait parameters during overground walking and challenging walking tasks. Notably, challenging walking accentuates GA, barring instances of obstacle circumvention coupled with dual-tasking, where GA appears to diminish. The simultaneous effort of consciously controlling walking while skillfully avoiding obstacles may, in fact, outweigh the available resources, consequently leading to changes in GA. Subsequently, potential mechanisms that could elucidate the genesis of GA within the PD population were presented. While the correlation between asymmetrical brain degeneration and GA appears logical, the precise neural mechanisms remain largely uncharted. This chapter was concluded with several recommendations pertinent to the realm of rehabilitation strategies were proffered. These recommendations are poised to augment our comprehension of GA in PD and, in turn, potentially steer interventions tailored to alleviate this condition.