Objective
To determine the effects of lower limb muscle fatigue on spatiotemporal gait parameters and turning difficulty characteristics during the extended Timed Up and Go (extended TUG) test in individuals with different severity stages of Parkinson’s disease (PD).
Methods
Forty individuals with PD, classified as Hoehn and Yahr (H&Y) stages 2 and 3 participated in this pre- and post-experimental study design. The participants performed a continuous sit-to-stand task from a chair based on 30 cycles/min set-up to induce lower limb muscle fatigue. They performed extended TUG test immediately before and after completing the fatigue protocol. Spatiotemporal gait parameters and turning difficulty characteristics were recorded using two GoPro® Hero 4 Silver cameras. Data were subjected to a repeated-measure ANOVA.
Results
Individuals with PD experience significant changes in spatiotemporal gait parameters, specifically stride velocity and length, under conditions of lower limb muscle fatigue (p=0.001). These changes were more pronounced in individuals with PD in the H&Y stage 3 group. Additionally, both PD groups exhibited difficulty with turning, requiring more than five steps to complete a 180° turn and taking more than 3 seconds to accomplish it.
Conclusion
These findings highlight the impact of muscle fatigue on gait performance in PD and suggest that individuals in later stages of the disease may be particularly affected. Further research is needed to explore interventions that can mitigate these gait impairments and improve mobility in individuals with PD.

Citations

• Fatigue‐Inducing Protocols in Parkinson’s Disease: Implications for Gait Assessment and Rehabilitation: A Systematic Review
  Mahdi Majlesi, Elaheh Azadian, Nader Farahpour, Rezvan Bakhtiarian, Hadi Nobari, Cristine Alves da Costa
  Parkinson's Disease.2026;[Epub]     CrossRef
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  Seo Jung Yun, Sung Eun Hyun, Woo Hyung Lee, Byung-Mo Oh, Han Gil Seo
  npj Parkinson's Disease.2025;[Epub]     CrossRef
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  Yunus Celik, Conor Wall, Jason Moore, Alan Godfrey
  Pragmatic and Observational Research.2025; Volume 16: 67.     CrossRef
• Association Between Turn Impairments and Cognitive Function in Parkinson Disease
  Shanhu Xu, Linlin Kong, Xiaoli Liu, Yue Lou, Luyan Gu, Qiuhan Xu, Xun Tan, Jiali Pu, Baorong Zhang
  AGING MEDICINE.2025; 8(4): 286.     CrossRef