The impact of Parkinson's Disease on interlimb coordination: a scoping review of gait adaptability.

Introduction: Interlimb coordination, the synchronization of movements between limbs, is essential for efficient and stable human movement. Disruptions in coordination contribute to gait dysfunction, a common challenge for individuals with Parkinson's disease (PD). This scoping review investigates how PD impairs interlimb coordination and influences gait adaptability, emphasizing the complexity of motor control challenges. Methods: This review assessed individuals with PD, focusing on spatiotemporal parameters and interlimb coordination within the Population, Concept, and Context (PCC) framework. A literature search was conducted across PubMed, Web of Science™, Scopus, SPORTDiscus, and Google Scholar™ in June 2023, following PRISMA-ScR guidelines. Risk of bias was assessed using an instrument proposed by Downs and Black (1998). Out of 710 studies, 14 met the inclusion criteria. Coordination was evaluated during treadmill or overground walking. Results: The review identified significant gait impairments in individuals with PD, including reduced walking velocity, step length, and range of motion. Coordination deficits were reflected in increased synchronization delays, phase shifts, and higher Phase Coordination Index values, particularly among those with freezing of gait. The findings emphasize the variability in PD's motor effects and highlight the need for individualized assessments and targeted strategies to address gait dysfunction and coordination impairments. Discussion: This review highlights the critical impact of PD on gait dynamics and interlimb coordination, reinforcing the need for personalized interventions aimed at improving coordination, enhancing mobility, reducing fall risk, and improving quality of life.