Pilot study using 2D sagittal-plane videogrammetry (Kinovea) to quantify knee ROM, within-subject variability, and interlimb coordination in 8 PD patients (ON/OFF meds) versus 27 controls, finding reduced ROM, increased variability, and impaired bilateral timing in OFF that partially improves with…

Offers a low-cost, interpretable gait-kinematic biomarker sensitive to dopaminergic state that could aid clinical monitoring or serve as an outcome measure in therapeutic trials, though small sample size and lack of mechanistic targets limit direct drug-discovery impact.

Background/Objectives: Freezing of gait (FoG) is a disabling motor manifestation of Parkinson's disease (PD) associated with impaired neural control of locomotion and increased gait variability. Quantitative characterization of gait kinematics may provide biomechanical insight into FoG-related instability, particularly under different dopaminergic states. Methods: This pilot study evaluated sagittal-plane knee kinematics in healthy individuals (n = 27) and patients with PD. (n = 8) under OFF and ON dopaminergic medication conditions using two-dimensional videogrammetry (Kinovea®). Knee flexion-extension trajectories were time-normalized to 0-100% of the gait cycle, and group ensemble profiles (mean ± SD) were computed. Results: Phase-specific range of motion (ROM), within-subject variability, and interlimb coordination were quantified. Interlimb coordination was assessed using Pearson's correlation coefficients (r) and cross-correlation lag analysis computed per subject and summarized statistically across groups. Compared with healthy participants, PD patients in the OFF state exhibited significantly reduced knee ROM during stance and swing (p < 0.05), accompanied by increased kinematic variability and disrupted temporal coordination. Interlimb correlation was significantly lower in PD OFF compared to healthy gait groups (p = 0.010), with larger temporal lags, indicating impaired bilateral synchronization. Following medication intake (ON state), knee excursion increased and interlimb coordination partially improved; however, correlation values and timing symmetry did not fully normalize to healthy levels. Conclusions: These findings demonstrate that sagittal-plane knee kinematics and interlimb coordination metrics derived from low-cost 2D videogrammetry are sensitive to the dopaminergic state and reveal persistent neuromotor deficits in PD. The proposed framework provides an interpretable and accessible approach for characterizing gait organization in Parkinson's disease and supports future integration with clinical assessment and longitudinal monitoring.