冻结步态与帕金森病患者的活动受限。

Freezing of gait and activity limitations in people with Parkinson's disease.

机构信息

School of Health Sciences, University of Melbourne, Melbourne, Australia.

出版信息

Arch Phys Med Rehabil. 2011 Jul;92(7):1159-65. doi: 10.1016/j.apmr.2011.02.003.

DOI:10.1016/j.apmr.2011.02.003

PMID:21704798

Abstract

OBJECTIVES

To investigate the relationships between freezing of gait (FOG) and activity limitations in ambulant people with Parkinson's disease (PD), and to explore the contribution of FOG and gait hypokinesia to activity limitations after adjusting for the effects of disease severity.

DESIGN

Retrospective, cross-sectional design.

SETTING

Participants were recruited from neurologists' clinics and the general public in metropolitan Melbourne, Australia.

PARTICIPANTS

Volunteers were screened for eligibility using the following inclusion criteria: diagnosis of idiopathic PD, modified Hoehn and Yahr stages 0 to IV, without dementia. Participants (N=210) were tested (mean age ± SD, 67.9±9.6y; mean PD duration ± SD, 6.7±5.6y; median Hoehn and Yahr stage=2.5).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

FOG was measured using the FOG questionnaire. Gait hypokinesia was quantified using both the 6-meter walk test and the Timed Up and Go test. Activity limitation was measured using the modified Unified Parkinson's Disease Rating Scale activities of daily living (ADL) section and the Schwab and England ADL scale.

RESULTS

Severity of gait freezing correlated significantly with the level of activity limitation (Spearman correlation coefficient, ρ=-.49 to .48; P<.001). A hierarchic regression model showed that disease severity explained 37.5% of the variance in Schwab and England ADL score (P<.001). Gait hypokinesia and FOG severity scores explained an additional 9.1% of the variance in activity limitation (R(2) change=.091; P<.001).

CONCLUSIONS

FOG severity and gait hypokinesia were associated with reduced levels of activity after adjusting for disease severity.

摘要

目的

研究冻结步态（FOG）与帕金森病（PD）患者活动受限之间的关系，并在调整疾病严重程度的影响后，探讨 FOG 和步态运动迟缓对活动受限的贡献。

设计

回顾性、横断面设计。

地点

参与者从澳大利亚墨尔本大都市的神经科诊所和普通人群中招募。

参与者

使用以下纳入标准筛选出符合条件的志愿者：特发性 PD 诊断，改良 Hoehn 和 Yahr 分期 0 至 IV 期，无痴呆。参与者（N=210）接受测试（平均年龄±标准差，67.9±9.6 岁；平均 PD 病程±标准差，6.7±5.6 岁；中位数 Hoehn 和 Yahr 分期=2.5）。

干预措施

不适用。

主要观察指标

FOG 使用 FOG 问卷进行测量。步态运动迟缓使用 6 米步行测试和计时起立和行走测试进行量化。活动受限使用改良的统一帕金森病评定量表日常生活活动（ADL）部分和 Schwab 和 England ADL 量表进行测量。

结果

步态冻结严重程度与活动受限水平显著相关（Spearman 相关系数，ρ=-.49 至.48；P<.001）。层次回归模型显示，疾病严重程度解释了 Schwab 和 England ADL 评分 37.5%的方差（P<.001）。步态运动迟缓与 FOG 严重程度评分解释了活动受限 9.1%的额外方差（R²变化=.091；P<.001）。