McAuley J H, Daly P M, Curtis C R
Department of Neurosciences, Royal London Hospital, Whitechapel, UK.
Clin Rehabil. 2009 Aug;23(8):687-95. doi: 10.1177/0269215509104170. Epub 2009 Apr 29.
Parkinson's disease is a relatively common progressive neurodegenerative disorder, one of whose main features is difficulty with walking. This can be partially corrected by providing cues for the placement of each step. We piloted the potential benefit of simple custom-designed 'walking glasses' worn by the patient that provide visual and auditory cues to aid in step placement.
We used a repeated measures design to compare gait performance when unaided and when using the walking glasses with different patterns of visual and auditory stimulation by timing patients' walking over a 'real-life' predefined 30-m course.
Hospital outpatient clinic.
Fifteen patients with idiopathic Parkinson's disease who had significant gait problems and no other condition affecting gait performance.
Timed walk.
Using the glasses, 8 of 15 patients achieved a significant and meaningful average improvement in walking time of at least 10% (mean (95% confidence interval) improvement in these patients was 21.5% (3.9%)), while a further 2 had subjective and modest objective benefit. Different patterns of visual and auditory cues suited different patients. Visual cueing alone with a fixed horizontal cue line present all the time statistically resulted in the greatest improvement in walking time.
This pilot study shows promising improvement in the gait of a significant proportion of Parkinson's disease patients through the use of a simple, inexpensive and robust design of walking glasses, suggesting practical applicability in a therapy setting to large numbers of such patients.
帕金森病是一种相对常见的进行性神经退行性疾病,其主要特征之一是行走困难。通过为每一步的放置提供线索,可以部分纠正这一问题。我们试用了患者佩戴的简单定制“行走眼镜”的潜在益处,这种眼镜可提供视觉和听觉线索以帮助放置脚步。
我们采用重复测量设计,通过记录患者在“现实生活”中预先定义的30米路线上行走的时间,比较在无辅助情况下以及使用具有不同视觉和听觉刺激模式的行走眼镜时的步态表现。
医院门诊。
15名特发性帕金森病患者,他们有明显的步态问题且没有其他影响步态表现的疾病。
定时步行。
使用眼镜后,15名患者中有8名在行走时间上平均有显著且有意义的改善,至少提高了10%(这些患者的平均(95%置信区间)改善为21.5%(3.9%)),另有2名患者有主观和适度的客观受益。不同的视觉和听觉线索模式适合不同的患者。始终存在固定水平线索线的单纯视觉提示在统计学上导致行走时间改善最大。
这项初步研究表明,通过使用简单、廉价且耐用的行走眼镜设计,相当一部分帕金森病患者的步态有了有前景的改善,这表明在治疗环境中对大量此类患者具有实际适用性。