Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Australia.
Parkinsonism Relat Disord. 2012 Feb;18(2):117-24. doi: 10.1016/j.parkreldis.2011.07.014. Epub 2011 Nov 16.
Gait disorders are common in people with Parkinson's disease (PD) yet their associations with activity limitations remain poorly understood. The objective of this review is to investigate the relationships between gait impairments and activity limitations in people with idiopathic PD. Six electronic databases (MEDLINE ISI, CINAHL, Web of Science ISI, EMBASE, PsycINFO and Scopus) were systematically searched using relevant terms to source for English-language studies published between 1900 and January 2011. Only studies that reported associations between impairments and activity limitations were considered for the review. The methodological quality of eligible studies was evaluated using a customized checklist by two independent reviewers. Data on participant characteristics, disease severity and associations between variables were extracted using a standardized data extraction form. Correlation coefficients were transformed to standardized scores and pooled using the fixed or random effects models. 16 of the 1735 studies screened were included, comprising 1882 participants. Large effect sizes were found between postural instability measured by the Berg Balance scale and activity limitation measured by the Unified Parkinson's Disease Rating Scale Activities of Daily Living (UPDRS ADL) section (-0.81; 95% CI, -0.99 to -0.63; p < 0.001). Gait hypokinesia measured by gait speed was significantly correlated with UPDRS ADL (-0.41; 95% CI, -0.56 to -0.26; p < 0.001). Gait freezing measured by the Freezing of Gait Questionnaire was associated with reduction in ADL (0.45; 95% CI, 0.36 to 0.54; p < 0.001). Knowledge of gait disturbances and their associations with disability may help to guide clinicians in assessing patients to optimize functional outcomes.
步态障碍在帕金森病（PD）患者中很常见，但它们与活动受限的关系仍不清楚。本综述的目的是探讨特发性 PD 患者步态障碍与活动受限之间的关系。我们系统性地检索了六个电子数据库（MEDLINE ISI、CINAHL、Web of Science ISI、EMBASE、PsycINFO 和 Scopus），使用相关术语查找 1900 年至 2011 年 1 月发表的英文研究。只有报告了障碍与活动受限之间的关联的研究才被纳入本综述。两名独立评审员使用定制的清单评估合格研究的方法学质量。使用标准化数据提取表提取参与者特征、疾病严重程度和变量之间关系的数据。使用固定或随机效应模型转换相关系数为标准化得分并进行合并。在筛选出的 1735 项研究中，有 16 项研究（共 1882 名参与者）被纳入。在 Berg 平衡量表测量的姿势不稳定与统一帕金森病评定量表日常生活活动（UPDRS ADL）部分测量的活动受限之间发现了较大的效应量（-0.81；95%CI，-0.99 至-0.63；p<0.001）。步态速度测量的步态迟缓与 UPDRS ADL 显著相关（-0.41；95%CI，-0.56 至-0.26；p<0.001）。冻结步态问卷测量的冻结步态与 ADL 减少相关（0.45；95%CI，0.36 至 0.54；p<0.001）。了解步态障碍及其与残疾的关系可能有助于指导临床医生评估患者，以优化功能结局。
