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一项评估个体听觉提示装置对帕金森病患者冻结现象和步速影响的随机对照试验。

A randomised controlled trial evaluating the effect of an individual auditory cueing device on freezing and gait speed in people with Parkinson's disease.

作者信息

Ledger Sean, Galvin Rose, Lynch Deirdre, Stokes Emma K

机构信息

Department of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Republic of Ireland.

出版信息

BMC Neurol. 2008 Dec 11;8:46. doi: 10.1186/1471-2377-8-46.

Abstract

BACKGROUND

Parkinson's disease is a progressive neurological disorder resulting from a degeneration of dopamine producing cells in the substantia nigra. Clinical symptoms typically affect gait pattern and motor performance. Evidence suggests that the use of individual auditory cueing devices may be used effectively for the management of gait and freezing in people with Parkinson's disease. The primary aim of the randomised controlled trial is to evaluate the effect of an individual auditory cueing device on freezing and gait speed in people with Parkinson's disease.

METHODS

A prospective multi-centre randomised cross over design trial will be conducted. Forty-seven subjects will be randomised into either Group A or Group B, each with a control and intervention phase. Baseline measurements will be recorded using the Freezing of Gait Questionnaire as the primary outcome measure and 3 secondary outcome measures, the 10 m Walk Test, Timed "Up & Go" Test and the Modified Falls Efficacy Scale. Assessments are taken 3-times over a 3-week period. A follow-up assessment will be completed after three months. A secondary aim of the study is to evaluate the impact of such a device on the quality of life of people with Parkinson's disease using a qualitative methodology.

CONCLUSION

The Apple iPod-Shuffle and similar devices provide a cost effective and an innovative platform for integration of individual auditory cueing devices into clinical, social and home environments and are shown to have immediate effect on gait, with improvements in walking speed, stride length and freezing. It is evident that individual auditory cueing devices are of benefit to people with Parkinson's disease and the aim of this randomised controlled trial is to maximise the benefits by allowing the individual to use devices in both a clinical and social setting, with minimal disruption to their daily routine.

摘要

背景

帕金森病是一种进行性神经疾病,由黑质中产生多巴胺的细胞退化所致。临床症状通常会影响步态模式和运动表现。有证据表明,使用个性化听觉提示设备可能对帕金森病患者的步态和冻结现象管理有效。该随机对照试验的主要目的是评估个性化听觉提示设备对帕金森病患者冻结现象和步态速度的影响。

方法

将进行一项前瞻性多中心随机交叉设计试验。47名受试者将被随机分为A组或B组,每组都有一个对照阶段和干预阶段。将使用步态冻结问卷作为主要结局指标,并采用3项次要结局指标,即10米步行测试、定时起立行走测试和改良跌倒效能量表来记录基线测量值。在3周内进行3次评估。3个月后将完成随访评估。该研究的次要目的是使用定性方法评估这种设备对帕金森病患者生活质量的影响。

结论

苹果iPod-Shuffle及类似设备为将个性化听觉提示设备整合到临床、社交和家庭环境中提供了一个经济高效且创新的平台,并且已证明对步态有即时影响,可改善步行速度、步幅和冻结现象。显然,个性化听觉提示设备对帕金森病患者有益,而这项随机对照试验的目的是通过让个体在临床和社交环境中使用设备,同时对其日常生活造成最小干扰,从而最大化益处。

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