Program in Physical Therapy, Washington University in St. Louis, St. Louis, MO, USA.
Parkinsonism Relat Disord. 2012 Nov;18(9):1022-6. doi: 10.1016/j.parkreldis.2012.05.019. Epub 2012 Jun 18.
Freezing of gait is a debilitating and common gait disturbance observed in individuals with Parkinson's disease (PD). Although the underlying mechanisms of freezing remain unclear, bilateral coordination of steps, measured as a phase coordination index, has been suggested to be related to freezing. Phase coordination index has not, however, been measured during tasks associated with freezing such as turning and backward walking. Understanding how bilateral coordination changes during tasks associated with freezing may improve our understanding of the causes of freezing.
Twelve individuals with PD who freeze (freezers), 19 individuals with PD who do not freeze (non-freezers), and 10 healthy, age-matched older adults participated. General motor disease severity and freezing severity were assessed. Phase coordination index was calculated for all subjects during forward walking, backward walking, continuous turning in small radius circles, and turning in large radius circles.
Freezers and non-freezers had similar disease duration and general motor severity. Stepping coordination (measured as phase coordination index) was significantly worse in freezers compared to non-freezers and controls. Turning and backward walking, tasks related to freezing, resulted in worse coordination with respect to forward walking. Coordination was associated with severity of freezing scores such that worse coordination was correlated with more severe freezing.
These results provide evidence that stepping coordination is related to freezing in people with PD. Identifying variables associated with freezing may provide insights into factors underlying this symptom, and may inform rehabilitative interventions to reduce its occurrence in PD.
冻结步态是帕金森病（PD）患者常见的一种致残步态障碍。尽管冻结的潜在机制尚不清楚，但步幅的双侧协调（以相位协调指数来衡量）与冻结有关。然而，在与冻结相关的任务（如转弯和后退行走）中，尚未测量相位协调指数。了解与冻结相关的任务中双侧协调如何变化，可能有助于我们了解冻结的原因。
12 名冻结的 PD 患者（冻结组）、19 名不冻结的 PD 患者（非冻结组）和 10 名年龄匹配的健康老年人参与了研究。评估了一般运动疾病严重程度和冻结严重程度。为所有受试者计算了在向前行走、向后行走、小半径连续转弯和大半径转弯时的相位协调指数。
冻结组和非冻结组的疾病持续时间和一般运动严重程度相似。与非冻结组和对照组相比，冻结组的步幅协调（以相位协调指数衡量）明显更差。转弯和后退行走是与冻结相关的任务，与向前行走相比，协调能力更差。协调与冻结评分的严重程度有关，即协调能力越差，冻结越严重。
这些结果提供了证据表明，PD 患者的步幅协调与冻结有关。确定与冻结相关的变量可能有助于深入了解该症状的潜在因素，并为减少 PD 中冻结的发生提供康复干预的信息。
