# Reduction of Festinating Clinical Gait Parameters to Near Normal After Hip Joint Mobilization: A Parkinson’s Disease Case Report

## TL;DR

Hip joint mobilization significantly improved gait in a Parkinson's patient, restoring near-normal walking speed and step length.

## Contribution

This case report introduces hip joint mobilization as a novel intervention for improving gait in Parkinson's disease.

## Key findings

- Hip joint mobilization led to a 20.4% increase in gait speed to 1.30 m/s.
- Step length improved by 30.2%, reaching 0.69 m, and cadence decreased to near-normal levels.
- Improvements were maintained for two weeks and allowed the patient to return to tennis.

## Abstract

People with Parkinson's disease (PD) walk with decreased speed and step length that worsen with disease progression. Despite treatments that yield statistically significant yet clinically small changes, normal gait parameters are rarely restored. Few PD studies assess joint passive range-of-motion concurrently with temporospatial gait parameters or joint mobilization effects on gait outcomes. This case introduces hip joint mobilizations for passive range of motion in PD and the unusual outcome of temporospatial gait parameters returning to near normal. A male with PD managed consistently pharmacologically presented with bradykinesia, rigidity, and characteristic festinating gait dysfunctions: slow speed, short step lengths, and fast cadence. Bilateral hip passive range of motion was impaired in all planes. He attended only two sessions for hip joint mobilizations and stretching. Hip passive range of motion increased. Temporospatial gait parameters also improved to near age-sex-matched normal: speed increased 20.4% from 1.08 to 1.30 m/s, well beyond the minimal clinically important difference; step length increased 30.2% from 0.53 to 0.69 m; and cadence decreased 7.3% from 2.05 to 1.90 steps/s. After two weeks, large clinically important intersession improvements remained in temporospatial gait parameters with near-normal gait speed without visible festination. Having returned to tennis, he considered his goals met and declined further care, still playing tennis seven months later. Controlled research exploring relationships among passive range of motion, joint mobilization, and gait parameters in PD is warranted.