Klenk Jochen, Srulijes Karin, Schatton Cornelia, Schwickert Lars, Maetzler Walter, Becker Clemens, Synofzik Matthis
Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany.
Neurodegener Dis. 2016;16(5-6):317-23. doi: 10.1159/000444802. Epub 2016 May 21.
Reduced ambulatory activity is a major burden in neurodegenerative disease (NDD), leading to severe restrictions in social participation and further deterioration of motor capacities. However, objective evidence on walking behavior patterns and components underlying this impairment and its decline with disease progression is scarce for many NDDs. We aimed to unravel the detailed metrics underlying the reduced ambulatory activity in selected NDDs, and their relation to disease duration. We hypothesized that progressively reduced ambulatory activity is a feature shared across different NDDs, characterized by changes in both common and distinct components.
Sixty-five subjects with NDD (n = 34 degenerative ataxia; n = 15 progressive supranuclear palsy, and n = 16 Parkinson's disease) and 38 healthy older adults (total n = 103) wore a three-axial accelerometer (activPAL3™) for 7 consecutive days. Detailed metrics of ambulatory activity were calculated.
The average daily walking duration was significantly decreased in all three NDDs, yet characterized by a differential pattern of changes in number and length of walking bouts and sit-to-stand transfers. Decline in walking duration progressed with increased disease duration in all three NDDs, yet at a differing rate. This decline was associated with progressive reductions in walking bout length and walking behavior pattern diversity in all three NDDs.
These findings provide objective evidence that reduced ambulatory activity is a shared feature across different NDDs. Moreover, they reveal that several underlying walking behavior components change with increasing disease duration, yet at a differing rate in different NDDs. This indicates that metric analysis of ambulatory activity might provide ecologically relevant and disease-specific progression and outcome markers in several NDDs.
步行活动减少是神经退行性疾病（NDD）的主要负担，导致社交参与严重受限以及运动能力进一步衰退。然而，对于许多神经退行性疾病而言，关于这种损伤背后的步行行为模式和组成部分及其随疾病进展而下降的客观证据却很匮乏。我们旨在揭示特定神经退行性疾病中步行活动减少背后的详细指标，以及它们与疾病持续时间的关系。我们假设步行活动逐渐减少是不同神经退行性疾病共有的特征，其特点是共同和不同组成部分都发生变化。
65名神经退行性疾病患者（n = 34例退行性共济失调；n = 15例进行性核上性麻痹，n = 16例帕金森病）和38名健康老年人（共n = 103）连续7天佩戴三轴加速度计（activPAL3™）。计算步行活动的详细指标。
所有三种神经退行性疾病的平均每日步行时长均显著减少，但步行次数、步行时长和坐立转换次数的变化模式有所不同。在所有三种神经退行性疾病中，步行时长的下降都随着疾病持续时间的增加而进展，但速度不同。这种下降与所有三种神经退行性疾病中步行时长和步行行为模式多样性的逐渐减少有关。
这些发现提供了客观证据，表明步行活动减少是不同神经退行性疾病的共同特征。此外，它们还揭示了几个潜在的步行行为组成部分会随着疾病持续时间的增加而变化，但在不同的神经退行性疾病中变化速度不同。这表明步行活动的指标分析可能为几种神经退行性疾病提供与生态相关且特定于疾病的进展和结局标志物。
