Radovanović S, Perić S, Savić-Pavićević D, Dobričić V, Pešović J, Kostić V, Rakočević-Stojanović V
Institute for Medical Research, University of Belgrade , Dr Subotića 4, 11129 Belgrade , Serbia.
Neurology Clinic, School of Medicine, University of Belgrade, Dr Subotića 6, 11000 Belgrade, Serbia.
Gait Posture. 2016 Feb;44:194-9. doi: 10.1016/j.gaitpost.2015.12.020. Epub 2015 Dec 20.
We analyzed temporal and stride characteristics in patients with myotonic dystrophy type 1 (DM1) and type 2 (DM2) while performing dual mental and motor tasks, and investigated correlations between gait parameters and cognitive impairments.
Dual-task walking was performed by 37 patients (20 DM1 and 17 DM2) and 48 healthy subjects divided into two groups, age- and gender-matched control group for DM1 (HC1) and age- and gender-matched control group for DM2 (HC2). The subjects performed a basic walking task, dual-motor task, dual-mental task, and combined motor and mental task.
DM1 and DM2 patients differed significantly in temporal and stride characteristics compared to HC. Main differences in DM1 were slower gait and shorter stride length, while both DM1 and DM2 patients had a higher degree of variation of the swing time during dual-task gait, a parameter that reflects posture and balance. Impact of the cognitive dual task on gait pattern changes was also observed. Visuospatial ability correlated with gait changes in DM1, while executive functions had stronger influence in DM2 (p<0.01). Both patient groups had leg muscle weakness.
Gait pattern was impaired in both patient groups concerning temporal and stride characteristics. Dual-task walking paradigm may discover mild initial gait changes and could provide early identification of fall risks and predict possible falls in DM patients.
我们分析了1型强直性肌营养不良（DM1）和2型强直性肌营养不良（DM2）患者在执行双重心理和运动任务时的时间和步幅特征，并研究了步态参数与认知障碍之间的相关性。
37例患者（20例DM1和17例DM2）和48名健康受试者进行了双任务步行，健康受试者分为两组，即与DM1年龄和性别匹配的对照组（HC1）和与DM2年龄和性别匹配的对照组（HC2）。受试者执行基本步行任务、双运动任务、双心理任务以及运动和心理组合任务。
与健康对照组相比，DM1和DM2患者在时间和步幅特征上存在显著差异。DM1的主要差异在于步态较慢和步幅较短，而DM1和DM2患者在双任务步态期间摆动时间的变化程度均较高，这一参数反映了姿势和平衡。还观察到认知双任务对步态模式变化的影响。视觉空间能力与DM1的步态变化相关，而执行功能在DM2中的影响更强（p<0.01）。两组患者均存在腿部肌肉无力。
两组患者的步态模式在时间和步幅特征方面均受损。双任务步行范式可能会发现轻度的初始步态变化，并可早期识别跌倒风险，预测DM患者可能发生的跌倒。
