Gait impairments are among the most common and disabling symptoms of Parkinson’s disease and worsen as the disease progresses. Early detection and diagnosis of subtype-specific gait deficits, as well as progression monitoring, can help to implement effective and preventive personalized treatment for PD patients. Yet, the gait features have not been fully studied in PD and its motor subtypes. To characterize comprehensive and objective gait alterations and to identify the potential gait biomarkers for early diagnosis, subtype differentiation, and disease severity monitoring. We analyzed gait parameters related to upper/lower limbs, trunk and lumbar, and postural transitions from 24 tremor-dominant (TD) and 20 postural instability gait difficulty (PIGD) dominant PD patients who were in early stage and 39 matched healthy controls (HC) during the Timed Up and Go test using wearable sensors. Results show: (1) Both TD and PIGD groups showed restricted backswing range in bilateral lower extremities and more affected side (MAS) arm, reduced trunk and lumbar rotation range in the coronal plane, and low turning efficiency. The receiver operating characteristic (ROC) analysis revealed these objective gait features had high discriminative value in distinguishing both PD subtypes from the HC with the area under the curve (AUC) values of 0.7~0.9 (p < 0.01). (2) Subtle but measurable gait differences existed between TD and PIGD patients before the onset of clinically apparent gait impairment. (3) Specific gait parameters were significantly associated with disease severity in TD and PIGD subtypes. Objective gait biomarkers based on wearable sensors may facilitate timely and personalized gait treatments in PD subtypes through early diagnosis, subtype differentiation, and disease severity monitoring.

步态障碍是帕金森病最常见和致残的症状之一，并且随着疾病的进展而恶化。早期检测和诊断亚型特异性步态缺陷以及进展监测，有助于对帕金森病患者实施有效的预防性个性化治疗。然而，帕金森病及其运动亚型的步态特征尚未得到充分研究。表征全面、客观的步态改变，并确定用于早期诊断、亚型区分和疾病严重程度监测的潜在步态生物标志物。我们分析了 24 名震颤主导型 (TD) 和 20 名姿势不稳步态困难 (PIGD) 为主的早期 PD 患者和 39 名匹配的健康对照 (HC) 的上/下肢、躯干和腰椎相关步态参数以及姿势转变。 ）在使用可穿戴传感器进行 Timed Up and Go 测试期间。结果显示：（1）TD组和PIGD组双侧下肢和受影响侧（MAS）臂的后摆幅度受限，躯干和腰椎在冠状面的旋转幅度减小，转身效率低。受试者工作特征（ROC）分析显示，这些客观步态特征在区分两种 PD 亚型和 HC 方面具有较高的判别价值，曲线下面积（AUC）值为 0.7~0.9（ p < 0.01）。 (2) 在出现临床明显步态障碍之前，TD 和 PIGD 患者之间存在细微但可测量的步态差异。 (3) TD 和 PIGD 亚型的特定步态参数与疾病严重程度显着相关。 基于可穿戴传感器的客观步态生物标志物可以通过早期诊断、亚型区分和疾病严重程度监测，促进及时、个性化的PD亚型步态治疗。