Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, United Kingdom.
Mov Disord. 2013 Sep 15;28(11):1534-43. doi: 10.1002/mds.25545.
Gait is emerging as a powerful measurement tool in neurodegenerative disorders to identify markers of incipient pathology, inform diagnostic algorithms and disease progression, and measure the efficacy of interventions. However, it is unclear which of the many gait outcomes is most appropriate for each of these purposes. In this review, we summarise key topics relating to gait measurement. We draw on literature from Parkinson's disease, ageing, and neurodegenerative disease to address the issue of variable selection with the goal of moving toward a structured approach to measurement. Findings from this review identify a wide range of spatiotemporal and dynamic characteristics; however, their suitability differs according to the aim of measurement. Gait speed is useful as a global characteristic of performance but may not capture the nature of underlying pathology. Inconsistent application, reporting, and interpretation of gait outcomes currently preclude a prescriptive approach. Conceptual models of gait may facilitate a reasoned approach to outcome selection. We also recommend harmonisation of protocols, longitudinal cohort studies, and use of novel technologies and methods of analysis to provide a complete picture of gait. Gait characteristics are "fit for purpose" when selected according to a clear rationale and in accordance with their clinimetric properties. Evidence supports the use of gait as a biomarker of disease and to complement diagnosis and inform disease management. A structured approach to measurement is urgently required to fully realise the contribution gait can make to our understanding of neurodegenerative disease.
步态正逐渐成为神经退行性疾病的一种强大的测量工具，用于识别早期病理的标志物、为诊断算法和疾病进展提供信息，并评估干预措施的效果。然而，目前尚不清楚对于这些目的中的每一个目的，众多步态结果中哪一个最合适。在这篇综述中，我们总结了与步态测量相关的关键主题。我们借鉴了帕金森病、衰老和神经退行性疾病的文献，以解决变量选择的问题，目标是朝着结构化的测量方法迈进。这项综述的研究结果确定了广泛的时空和动态特征；然而，根据测量的目的，它们的适用性不同。步态速度作为性能的整体特征很有用，但可能无法捕捉潜在病理的本质。目前，步态结果的应用、报告和解释不一致，无法采用规定的方法。步态的概念模型可能有助于合理选择结果。我们还建议协调协议、进行纵向队列研究以及使用新技术和分析方法，以全面了解步态。根据明确的基本原理并根据其临床计量特性选择步态特征时，它们是“合适的”。有证据支持将步态用作疾病的生物标志物，以补充诊断并为疾病管理提供信息。迫切需要采用结构化的测量方法，以充分发挥步态对我们理解神经退行性疾病的贡献。
