Herfurth Manon, Godau Jana, Kattner Barbara, Rombach Silvia, Grau Stefan, Maetzler Walter, Berg Daniela
German Center of Neurodegenerative Diseases, University of Tübingen, Germany.
Klinikum Kassel, Department of Neurology and Kassel Medical School, University of Southampton, Kassel, Germany.
Parkinsonism Relat Disord. 2015 Apr;21(4):413-6. doi: 10.1016/j.parkreldis.2015.01.016. Epub 2015 Feb 7.
The impact of Nordic walking (NW) in Parkinson's disease (PD) has been investigated in several studies but results are inconsistent. This may be due to different cohorts studied and the heterogeneity of their PD symptoms which impact the outcome of NW. This study aimed at determining predictive factors for a positive effect of NW on PD.
Primary outcome was to define the baseline disease-associated and demographic parameters that distinguish patients who demonstrate improvement in the Unified PD rating scale (UPDRS) motor part following NW training ("U+") from those patients with no improvement after the same intervention ("U-"). The potentially predictive parameters were: age, age at onset, disease duration, gait velocity, step length, daily step number, UPDRS-motor part, Berg-Balance-Scale, Parkinson-Neuropsychometric-Dementia-Assessment, verbal-fluency-test and Becks-Depression-Inventory-II. Twenty-two PD patients (H&Y stage 2-2.5) performed twelve weeks of NW training. Eighteen patients were included in the final analysis. Overall, the UPDRS motor part did not improve significantly; however, eight patients had an improvement in the UPDRS motor part from baseline to end of study (U+). When comparing the potentially predictive factors of the U+ cohort with those ten patients who did not improve (U-), there was a notable difference in gait velocity and step length, and showed a significant correlation with an improvement in the UDPRS motor part scores.
Gait velocity and step length can predict the outcome of NW training as determined by the UPDRS motor part, indicating that PD patients with only slightly impaired gait performance benefit most.
多项研究对健走（NW）在帕金森病（PD）中的影响进行了调查，但结果并不一致。这可能是由于所研究的队列不同以及其PD症状的异质性影响了NW的结果。本研究旨在确定NW对PD产生积极影响的预测因素。
主要结果是确定基线疾病相关和人口统计学参数，以区分在NW训练后统一PD评定量表（UPDRS）运动部分表现出改善的患者（“U+”）与在相同干预后无改善的患者（“U-”）。潜在的预测参数为：年龄、发病年龄、病程、步速、步长、每日步数、UPDRS运动部分、伯格平衡量表、帕金森神经心理痴呆评估、语言流畅性测试和贝克抑郁量表第二版。22例PD患者（H&Y分期2-2.5）进行了12周的NW训练。18例患者纳入最终分析。总体而言，UPDRS运动部分没有显著改善；然而，8例患者的UPDRS运动部分从基线到研究结束有所改善（U+）。将U+队列的潜在预测因素与10例未改善的患者（U-）进行比较时，步速和步长存在显著差异，并且与UPDRS运动部分评分的改善呈显著相关。
步速和步长可以预测由UPDRS运动部分确定的NW训练结果，表明步态表现仅轻微受损的PD患者受益最大。
