Louis Elan D, Galecki Monica, Rao Ashwini K
GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America ; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America ; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America ; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America.
Tremor Other Hyperkinet Mov (N Y). 2013 Nov 4;3. doi: 10.7916/D8QV3K7G. eCollection 2013.
A body of literature is emerging regarding gait/balance impairments observed in essential tremor (ET) patients. Although impairment is generally mild, the full extent of the spectrum remains undefined. We present four ET cases with more severe gait/balance impairment.
A BATTERY OF SUBJECTIVE AND OBJECTIVE GAIT/BALANCE ASSESSMENTS WAS PERFORMED: the Activities-specific Balance Confidence Scale, the Berg Balance Scale, and the Tinetti Performance Oriented Mobility Assessment (POMA). Tandem missteps during 10 steps were counted. Quantitative gait testing was performed (GAITRite) to quantify gait speed, dynamic balance, gait symmetry, and gait variability.
Two patients were middle-aged (38 and 52 years) and two were older (70 and 79 years). All had longstanding classic ET (duration 22-60 years). The mean POMA score was 21.5, which is indicative of moderate fall risk. On average, there were five missteps during tandem gait, which was higher than observed in substantially older ET cases (age 86.0±4.6 years), and four times higher than seen in ET patients of comparable age. On quantitative gait analysis, patients demonstrated significant balance impairment.
We present a sample of ET patients with a level of gait difficulty that would not be characterized as mild. The existence of such cases raises a number of questions, one of which is how impaired can gait be in ET?
关于在特发性震颤（ET）患者中观察到的步态/平衡障碍，相关文献正在不断涌现。尽管这种障碍通常较轻，但整个谱系的全貌仍不明确。我们报告了4例步态/平衡障碍更为严重的ET病例。
进行了一系列主观和客观的步态/平衡评估：特定活动平衡信心量表、伯格平衡量表和Tinetti以性能为导向的移动性评估（POMA）。计算10步串联行走时的失误次数。进行定量步态测试（GAITRite）以量化步态速度、动态平衡、步态对称性和步态变异性。
2例患者为中年（38岁和52岁），2例为老年（70岁和79岁）。所有患者均患有长期的典型ET（病程22 - 60年）。POMA平均得分为21.5，表明存在中度跌倒风险。串联步态平均有5次失误，高于在年龄大得多的ET病例（86.0±4.6岁）中观察到的次数，是同龄ET患者的4倍。在定量步态分析中，患者表现出明显的平衡障碍。
我们展示了一组步态困难程度并非轻度的ET患者样本。这些病例的存在引发了许多问题，其中之一是ET患者的步态能受损到何种程度？
