Gait in Parkinson Disease: From Neurophysiology to Rehabilitation Overview

Introduction: Parkinson's disease (PD) is a chronic and progressive neurodegenerative disorder, mostly happened in older adult, related to the degeneration of striatal dopaminergic neurons. Motor disorders in PD lead to gait disturbance, which worsen as the disease progresses. This literature review provides variety of gait disturbances possible in patients with PD. Understanding the mechanisms and factors associated with impaired walking activity of PD patients will form a solid foundation for selecting appropriate rehabilitation strategies, ultimately improving mobility, overcoming restriction of participation and life satisfaction for these patients. Methods: Research was conducted using PubMed, Google Scholar, and the Cochrane Library to locate original articles, as well as systematic and narrative reviews, concerning the neurophysiology, pathophysiology, clinical features, and rehabilitation of gait in Parkinson disease Result: PD Patients may experience a decrease in walking speed and stride length and increased axial rigidity. Early alterations in gait associated with PD include reduced arm swing amplitude, asymmetry between the extremities, and a decline in movement fluidity. In later stages, freezing of gait (FOG), festination, and turning en bloc can occur. These conditions will lead to increased dependency and affecting the patient's mobility and participation with further implication of immobility and isolation. Management of gait in Parkinson's disease (PD) consists of a combination of pharmacological and non-pharmacological treatment. A rehabilitation program designed for PD should cover the specific needs of each patient to optimize mobility and social participation. Conclusion: Understanding the neurophysiology of walking and the neuropathology of PD, the effective rehabilitation strategies can be formulated to optimize mobility, efficiency and the independency in daily activities, especially related to gait and walking performance.