L-Dopa Comparably Improves Gait and Limb Movements in Parkinson's Disease: A Wearable Sensor Analysis.

Background/Objectives: Spatio-temporal gait parameters have been proposed as surrogate markers for objective, remote monitoring of global motor status in Parkinson's disease (PD). Our observational, cross-sectional pilot study tested whether gait metrics, derived from wearable sensors, reflect dopaminergic responsiveness in both axial and appendicular functions. Methods: Twenty-two PD patients were evaluated both under and not under L-Dopa (ON and OFF states, respectively). Motor performance was assessed using wearable inertial sensors during standardized tasks involving gait and upper/lower limb movements. From the recorded kinematics, measures of movement amplitude, speed, rhythm, and consistency were extracted, and dopaminergic response was compared in appendicular and axial functions. Results: Treatment effects were more pronounced on the more affected body side. Improvements in appendicular amplitude, speed, and consistency closely matched those observed in spatio-temporal gait parameters. In contrast, rhythm measures displayed a divergent pattern, with reduced gait cadence but increased hand movement frequency, showing an inverse correlation. No significant correlations emerged between axial and appendicular domains for amplitude, velocity, or consistency, whereas improvements in step length and gait velocity were associated with MDS-UPDRS III motor scores. Conclusions: These findings overall suggest that specific gait metrics, particularly those reflecting amplitude and velocity, may provide reliable, sensor-based indicators of overall motor status in PD, supporting their use in remote monitoring.