Stolze H, Klebe S, Petersen G, Raethjen J, Wenzelburger R, Witt K, Deuschl G
Department of Neurology, Christian-Albrechts-Universität Kiel, Niemannsweg 147, D-24105 Kiel, Germany.
J Neurol Neurosurg Psychiatry. 2002 Sep;73(3):310-2. doi: 10.1136/jnnp.73.3.310.
Although gait disturbance is one of the most pronounced and disabling symptoms in cerebellar disease (CD), quantitative studies on this topic are rare.
To characterise the typical clinical features of cerebellar gait and to analyse ataxia quantitatively.
Twelve patients with various cerebellar disorders were compared with 12 age matched controls. Gait was analysed on a motor driven treadmill using a three dimensional system. A tandem gait paradigm was used to quantify gait ataxia.
For normal locomotion, a significantly reduced step frequency with a prolonged stance and double limb support duration was found in patients with CD. All gait measurements were highly variable in CD. Most importantly, balance related gait variables such as step width and foot rotation angles were increased in CD, indicating the need for stability during locomotion. The tandem gait paradigm showed typical features of cerebellar ataxia such as dysmetria, hypometria, hypermetria, and inappropriate timing of foot placement.
Typical features of gait in CD are reduced cadence with increased balance related variables and an almost normal range of motion (with increased variability) in the joints of the lower extremity. The tandem gait paradigm accentuates all the features of gait ataxia and is the most sensitive clinical test.
尽管步态障碍是小脑疾病(CD)最明显且致残的症状之一,但关于该主题的定量研究却很少。
描述小脑性步态的典型临床特征并对共济失调进行定量分析。
将12例患有各种小脑疾病的患者与12例年龄匹配的对照者进行比较。使用三维系统在电动跑步机上分析步态。采用串联步态模式对步态共济失调进行量化。
对于正常行走,CD患者的步频显著降低,站立时间和双下肢支撑时间延长。CD患者的所有步态测量结果变化很大。最重要的是,CD患者中与平衡相关的步态变量如步宽和足部旋转角度增加,表明行走过程中需要稳定性。串联步态模式显示出小脑共济失调的典型特征,如辨距不良、动作幅度减小、动作幅度增大以及足部放置时间不当。
CD患者步态的典型特征是步频降低,与平衡相关的变量增加,下肢关节的活动范围几乎正常(但变异性增加)。串联步态模式突出了步态共济失调的所有特征,是最敏感的临床测试。