Evaluation of gait initiation parameters using inertial sensors in Huntington’s Disease:insights into anticipatory postural adjustments and cognitive interference

Abstract Background Understanding the contribution of anticipatory postural adjustments (APA) on walking ability in individuals with Huntington’s disease (HD) may provide insight into motor planning and the functional consequences of HD-specific cortical-basal ganglia pathway dysfunctions. Research question How do inertial measurement unit (IMU)-derived APAs and first step parameters differ between individuals with HD and controls under no load and cognitive load conditions, and what is their relationship to gait speed and clinical measures? Methods 33 individuals with manifest HD and 15 age-matched healthy controls wore three Opal APDM IMUs during a 14-meter walk during a no load and cognitive load condition. APA acceleration amplitudes, APA durations, first step range of motion (ROM), and first step duration were compared, along with their relationship to gait speed. Results Individuals with HD had greater APA acceleration amplitudes, smaller first step ROM and longer first step durations compared to healthy controls. No differences in APA durations were present between groups in both conditions; cognitive loading did not affect the APA parameters. Mediolateral APA acceleration amplitudes were a significant predictor of gait speed and were related to disease-specific measures. Significance Larger acceleration amplitudes and smaller first step ROMs of greater duration, accompanied by the preservation of APA durations, reveal a discrepancy in movement scaling in HD. Additionally, the mediolateral component of the APA is likely a rate-limiting factor that drives a compensatory response in gait initiation. Further research is needed to explore the neural correlates of HD-related movement scaling.