El-Tamawy Mohamed S, Darwish Moshera H, Khallaf Mohamed E
Department of Neurology, College of Medicine, Cairo University, Egypt.
Ann Indian Acad Neurol. 2012 Oct;15(4):267-72. doi: 10.4103/0972-2327.104334.
Impairment of initiating sequential movements and processing of proprioception contribute to characteristic Parkinson's disease (PD) gait abnormalities. Many studies have used a single external cue or 2 different cues to correct PD gait.
An aim of this study was to determine the influence of paired proprioceptive cues on gait parameters of individuals with PD.
Double-blind randomized controlled trial.
Subjects were 30 PD patients who had mild to moderate impairment according to the United Parkinson's Disease Rating Scale (UPDRS). They were randomly assigned to either a routine physiotherapy program or treadmill training with vibratory stimuli applied to the feet plantar surfaces and proprioceptive neuromuscular facilitation (PNF) as well as the same physiotherapy program. All Participants received a 45-minutes session of low intensity physiotherapy program, 3 times a week, for 8 weeks. The duration of treadmill training was 5 minutes at baseline and 25 minutes at the end of treatment. Walking speed and distance were recorded from the treadmill control panel for both groups before and immediately after the end of treatment. The Qualysis ProReflex motion analysis system was used to measure cadence, stride length, hip, knee, and ankle joints' angular excursion.
The cadence, stride length, and lower limb joints' angular excursion showed a significant improvement in both groups (P ≤ 0.05). These improvements in spatio-temporal parameters and angular excursion were higher in the study group than in the control group (P ≤ 0.05).
Potentiated proprioceptive feedback improves parkinsonian gait kinematics, the hip, knee, and ankle joints' angular excursion.
启动连续动作和本体感觉处理受损会导致帕金森病（PD）特有的步态异常。许多研究使用单一外部提示或两种不同提示来纠正PD步态。
本研究的目的是确定配对本体感觉提示对PD患者步态参数的影响。
双盲随机对照试验。
受试者为30例根据统一帕金森病评定量表（UPDRS）有轻度至中度损伤的PD患者。他们被随机分配到常规物理治疗方案组或在足底表面施加振动刺激的跑步机训练组，同时进行本体感觉神经肌肉促进法（PNF）以及相同的物理治疗方案。所有参与者每周接受3次，每次45分钟的低强度物理治疗方案，共8周。跑步机训练的持续时间在基线时为5分钟，治疗结束时为25分钟。在治疗结束前和结束后立即从跑步机控制面板记录两组的步行速度和距离。使用Qualysis ProReflex运动分析系统测量步频、步长、髋、膝和踝关节的角位移。
两组的步频、步长和下肢关节角位移均有显著改善（P≤0.05）。研究组在时空参数和角位移方面的改善高于对照组（P≤0.05）。
增强的本体感觉反馈可改善帕金森步态运动学，即髋、膝和踝关节的角位移。
