Cavanaugh James T, Ellis Terry D, Earhart Gammon M, Ford Matthew P, Foreman K Bo, Dibble Leland E
J.T. Cavanaugh, PT, PhD, Department of Physical Therapy, University of New England, Portland, ME 04103 (USA).
T.D. Ellis, PT, PhD, Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts.
Phys Ther. 2015 Aug;95(8):1142-50. doi: 10.2522/ptj.20140498. Epub 2015 Apr 9.
Declining ambulatory activity represents an important facet of disablement in Parkinson disease (PD).
The primary study aim was to compare the 2-year trajectory of ambulatory activity decline with concurrently evolving facets of disability in a small cohort of people with PD. The secondary aim was to identify baseline variables associated with ambulatory activity at 1- and 2-year follow-up assessments.
This was a prospective, longitudinal cohort study.
Seventeen people with PD (Hoehn and Yahr stages 1-3) were recruited from 2 outpatient settings. Ambulatory activity data were collected at baseline and at 1- and 2-year annual assessments. Motor, mood, balance, gait, upper extremity function, quality of life, self-efficacy, and levodopa equivalent daily dose data and data on activities of daily living also were collected.
Participants displayed significant 1- and 2-year declines in the amount and intensity of ambulatory activity concurrently with increasing levodopa equivalent daily dose. Worsening motor symptoms and slowing of gait were apparent only after 2 years. Concurrent changes in the remaining clinical variables were not observed. Baseline ambulatory activity and physical performance variables had the strongest relationships with 1- and 2-year mean daily steps.
The sample was small and homogeneous.
Future research that combines ambulatory activity monitoring with a broader and more balanced array of measures would further illuminate the dynamic interactions among evolving facets of disablement and help determine the extent to which sustained patterns of recommended daily physical activity might slow the rate of disablement in PD.
动态活动能力下降是帕金森病（PD）致残的一个重要方面。
主要研究目的是比较一小群帕金森病患者动态活动能力下降的2年轨迹与同时期残疾状况的演变。次要目的是确定在1年和2年随访评估中与动态活动能力相关的基线变量。
这是一项前瞻性纵向队列研究。
从2个门诊机构招募了17名帕金森病患者（Hoehn和Yahr分期为1 - 3期）。在基线以及1年和2年的年度评估时收集动态活动数据。还收集了运动、情绪、平衡、步态、上肢功能、生活质量、自我效能、左旋多巴等效日剂量数据以及日常生活活动数据。
参与者在1年和2年时动态活动的量和强度显著下降，同时左旋多巴等效日剂量增加。仅在2年后运动症状恶化和步态减慢才明显。未观察到其余临床变量的同时变化。基线动态活动和身体性能变量与1年和2年的平均每日步数关系最为密切。
样本量小且同质化。
未来将动态活动监测与更广泛、更均衡的一系列测量方法相结合的研究，将进一步阐明致残状况演变各方面之间的动态相互作用，并有助于确定推荐的日常体育活动持续模式可能减缓帕金森病致残率的程度。
