Effects of levodopa on forward and backward gait patterns in persons with Parkinson's disease

Introduction: Backward walking is difficult for persons with Parkinson's disease (PD). It is unknown how levodopa influences backward gait patterns, especially when compared to forward gait patterns. Purpose: Investigate the effects of levodopa on forward and backward gait patterns in individuals with PD. Design: A repeated measures design was used. Methods: The sample consisted of 21 individuals with PD (15 males, 6 females). Their mean age was 70.24 ± 8.69 yr. The average time since diagnosis was 11.81 ± 5.49 years. The median of the Hoehn and Yahr stage while 'ON' medication was 2.57. Gait patterns during forward and backward walking at a self-selected comfortable speed were recorded before and after taking levodopa on the same day. Results: Levodopa significantly increased gait speed and stride length and decreased the percent of the gait cycle (%GC) spent in double support. Gait speed and stride length were greater and the %GC spent in double support was less during forward walking compared with backward walking. Cadence was not changed by levodopa or walking direction. Conclusions: Levodopa improved gait characteristics during backward walking in a manner similar to that during forward walking in persons with PD.