帕金森病 Hoehn-Yahr Ⅲ期跌倒风险。

Risk of falling in Parkinson's disease at the Hoehn-Yahr stage III.

机构信息

Department of Neurology, Nara Medical University, Kashihara, Japan.

出版信息

Eur Neurol. 2011;66(5):298-304. doi: 10.1159/000331635. Epub 2011 Nov 1.

DOI:10.1159/000331635

PMID:22057308

Abstract

BACKGROUND

It is difficult to predict the risk of falling, especially in patients with good motor ability, and the mechanisms underlying the relation between gait patterns and falling in Parkinson's disease (PD) remain unclear. We investigated factors related to falling, including walking speed and time, in patients with Hoehn-Yahr stage III PD.

METHODS

We performed clinical assessments and evaluated balance in 30 patients with PD. Information on falling was obtained from questionnaires and personal interviews. Gait patterns were analyzed with the use of an originally designed, suddenly narrowed path.

RESULTS

Gait velocity was slower in fallers than in non-fallers (p = 0.047). Unified Parkinson's Disease Rating Scale part II (UPDRS part II) score, fear of falling, and gait velocity were significantly related to falling on analysis with a single logistic model. When a multiple logistic model was used, the UPDRS part II score was significantly related to falling (OR: 1.48, p = 0.037, 95% CI: 1.02-2.16).

CONCLUSIONS

Patients with Hoehn-Yahr stage III PD showed slow gait velocity attributed to fear of falling before arrival at a narrowed entrance or while walking on a narrowed path. The UPDRS part II score is significantly related to the risk of future falls.

摘要

背景

很难预测跌倒的风险，尤其是在运动能力良好的患者中，帕金森病（PD）患者步态模式与跌倒之间的关系的机制仍不清楚。我们研究了与跌倒相关的因素，包括亨延顿病 III 期 PD 患者的行走速度和时间。

方法

我们对 30 名 PD 患者进行了临床评估和平衡评估。通过问卷调查和个人访谈获得跌倒信息。使用原创设计的突然变窄的路径分析步态模式。

结果

与非跌倒者相比，跌倒者的步态速度较慢（p = 0.047）。使用单因素逻辑模型分析时，统一帕金森病评定量表第二部分（UPDRS 第二部分）评分、对跌倒的恐惧和步态速度与跌倒明显相关。使用多因素逻辑模型时，UPDRS 第二部分评分与跌倒明显相关（OR：1.48，p = 0.037，95%CI：1.02-2.16）。