University of Munich, Graduate School of Systemic Neurosciences, Munich, Germany.
Gait Posture. 2013 Feb;37(2):214-8. doi: 10.1016/j.gaitpost.2012.07.003. Epub 2012 Jul 27.
This study investigated the influence of impaired cerebellar locomotion function on the magnitude and structure of stride-to-stride fluctuations in the walking pattern. On the basis of studies reporting a dependency of variability magnitude and structure on the walking speed, we hypothesized that patients with cerebellar ataxia (CA) would show alterations of gait variability in a speed-dependent manner.
11 patients with CA [7 idiopathic sporadic ataxia, 4 inherited spinocerebellar ataxia] and 11 healthy subjects (HS) walked on a treadmill for 5-min periods at their preferred walking speed and at 20%, 40%, 70%, and 80% of maximal walking speed. The variability magnitude of stride time, stride length and base width was calculated, and long-range correlations were detected by a detrended fluctuation analysis.
Both temporal and spatial gait variability were impaired in CA. Variability magnitude and structure of all examined parameters depended on the walking speed. The preferred walking speed of patients was linked to minimal levels of stride time and stride length variability magnitude and to the strongest correlations within the fluctuations of these parameters. Long-range correlations were present for all examined gait parameters in patients and HS. Compared to HS, patients showed alterations in the speed dependency of stride time and stride length variability, with increased variability occurring at slow and maximal pace, whereas base width variability remained unaffected.
Gait variability and therefore walking stability is critically dependent on the walking speed in patients with CA. At preferred walking speed, however, variability is minimal and similar to HS.
本研究旨在探讨小脑运动功能障碍对步行模式中步间波动幅度和结构的影响。基于研究报道称变异性幅度和结构依赖于行走速度,我们假设小脑性共济失调(CA)患者的步态变异性会以速度依赖的方式发生改变。
11 名 CA 患者(7 名特发性散发性共济失调,4 名遗传性脊髓小脑共济失调)和 11 名健康受试者(HS)在跑步机上以其惯用步行速度和最大步行速度的 20%、40%、70%和 80%进行 5 分钟的步行。计算步时、步长和基底宽度的变异性幅度,并通过去趋势波动分析检测长程相关性。
CA 患者的时间和空间步态变异性均受损。所有检查参数的变异性幅度和结构均依赖于步行速度。患者的惯用步行速度与步时和步长变异性幅度的最小水平相关,与这些参数波动中的最强相关性相关。所有检查的步态参数在患者和 HS 中均存在长程相关性。与 HS 相比,患者在步时和步长变异性的速度依赖性方面表现出改变,在缓慢和最大步速时变异性增加,而基底宽度变异性不受影响。
在 CA 患者中,步态变异性,因此步行稳定性严重依赖于步行速度。然而,在惯用步行速度下,变异性最小且与 HS 相似。