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J Appl Physiol 88: 2045-2053, 2000;
8750-7587/00 $5.00
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Vol. 88, Issue 6, 2045-2053, June 2000

Dynamic markers of altered gait rhythm in amyotrophic lateral sclerosis

Jeffrey M. Hausdorff1,2,4, Apinya Lertratanakul1, Merit E. Cudkowicz3,4, Amie L. Peterson2, David Kaliton2, and Ary L. Goldberger1,4

1 Margret and H. A. Rey Laboratory for Nonlinear Dynamics in Medicine and 2 Gerontology Division, Beth Israel Deaconess Medical Center, Boston 02215; 3 Neurology Department, Massachusetts General Hospital, Boston 02114; and 4 Harvard Medical School, Boston, Massachusetts 02115

Amyotrophic lateral sclerosis (ALS) is a disorder marked by loss of motoneurons. We hypothesized that subjects with ALS would have an altered gait rhythm, with an increase in both the magnitude of the stride-to-stride fluctuations and perturbations in the fluctuation dynamics. To test for this locomotor instability, we quantitatively compared the gait rhythm of subjects with ALS with that of normal controls and with that of subjects with Parkinson's disease (PD) and Huntington's disease (HD), pathologies of the basal ganglia. Subjects walked for 5 min at their usual pace wearing an ankle-worn recorder that enabled determination of the duration of each stride and of stride-to-stride fluctuations. We found that the gait of patients with ALS is less steady and more temporally disorganized compared with that of healthy controls. In addition, advanced ALS, HD, and PD were associated with certain common, as well as apparently distinct, features of altered stride dynamics. Thus stride-to-stride control of gait rhythm is apparently compromised with ALS. Moreover, a matrix of markers based on gait dynamics may be useful in characterizing certain pathologies of motor control and, possibly, in quantitatively monitoring disease progression and evaluating therapeutic interventions.

nervous system diseases; Huntington's disease; Parkinson's disease; motor control; nonlinear dynamics


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