Department of Neurology, University Hospital, Ludwig-Maximilian-University, 81366 Munich, Germany.
Restor Neurol Neurosci. 2010;28(1):115-22. doi: 10.3233/RNN-2010-0532.
Gait difficulties occur early in the course of Parkinson's disease (PD) as well as in generalized dystonia. Deep brain stimulation (DBS) is an effective treatment for patients with PD or dystonia. PD-associated slowness of gait improves dramatically after this procedure. Since not all gait problems can be treated with DBS, it is mandatory to assess the patient's symptoms precisely before an operation can be considered. In advanced stages of PD, postural deficits causing frequent falls are a major concern and will necessitate other strategies. In dystonia, walking may become possible only after this surgical intervention. After the implantation of DBS electrodes, rehabilitative treatment is necessary to (i) to establish new movement patterns, (ii) preserve an appropriate activity level, and (iii) treat specific disability, which resulted from secondary changes of the musculoskeletal system during pathological muscle tension in dystonia. An integrated multimodal approach, which has been adopted in our institution is presented.
步态困难在帕金森病 (PD) 以及全身性肌张力障碍的病程早期就会出现。脑深部电刺激 (DBS) 是治疗 PD 或肌张力障碍患者的有效方法。该手术可显著改善 PD 相关的步态迟缓。由于并非所有步态问题都可以通过 DBS 治疗，因此在考虑手术之前，必须精确评估患者的症状。在 PD 的晚期，导致频繁跌倒的姿势缺陷是一个主要问题，这将需要其他策略。在肌张力障碍中，只有在这种手术干预之后，行走才有可能。在植入 DBS 电极后，需要进行康复治疗，以：(i) 建立新的运动模式，(ii) 保持适当的活动水平，以及 (iii) 治疗因肌张力障碍病理性肌肉紧张导致的肌肉骨骼系统继发性变化而产生的特定残疾。本文介绍了我们机构采用的一种综合多模式方法。
