Danoudis Mary, Ganesvaran Ganga, Iansek Robert
Clinical Research Centre for Movement Disorders and Gait, The National Parkinson Foundation Center of Excellence, Kingston Centre, Monash Health, Cheltenham, Victoria 3192, Australia.
Department of Medicine, Monash University, Clayton 3800, Australia.
Gait Posture. 2016 Jul;48:47-51. doi: 10.1016/j.gaitpost.2016.04.026. Epub 2016 May 6.
The underlying mechanisms responsible for the gait changes in frontal gait disorder (FGD), a form of higher level gait disorders, are poorly understood. We investigated the relationship between stride length and cadence (SLCrel) in people with FGD (n=15) in comparison to healthy older adults (n=21) to improve our understanding of the changes to gait in FGD. Gait data was captured using an electronic walkway system as participants walked at five self-selected speed conditions: preferred, very slow, slow, fast and very fast. Linear regression was used to determine the strength of the relationship (R(2)), slope and intercept. In the FGD group 9 participants had a strong SLCrel (linear group) (R(2)>0.8) and 6 a weak relationship (R(2)<0.8) (nonlinear group). The linear FGD group did not differ to healthy control for slope (p>0.05) but did have a lower intercept (p<0.001). The linear FGD group modulated gait speed by adjusting stride length and cadence similar to controls whereas the nonlinear FGD participants adjusted stride length but not cadence similar to controls. The non-linear FGD group had greater disturbance to their gait, poorer postural control and greater fear of falling compared to the linear FGD group. Investigation of the SLCrel resulted in new insights into the underlying mechanisms responsible for the gait changes found in FGD. The findings suggest stride length regulation was disrupted in milder FGD but as the disorder worsened, cadence control also became disordered resulting in a break down in the relationship between stride length and cadence.
额叶步态障碍（FGD）是一种高级步态障碍，其导致步态改变的潜在机制尚不清楚。我们调查了FGD患者（n = 15）与健康老年人（n = 21）的步幅长度与步频（SLCrel）之间的关系，以增进我们对FGD中步态变化的理解。当参与者在五个自我选择的速度条件下行走时，使用电子步道系统采集步态数据：偏好速度、非常慢、慢、快和非常快。使用线性回归来确定关系强度（R(2)）、斜率和截距。在FGD组中，9名参与者具有强SLCrel（线性组）（R(2)>0.8），6名参与者具有弱关系（R(2)<0.8）（非线性组）。线性FGD组与健康对照组在斜率上无差异（p>0.05），但截距较低（p<0.001）。线性FGD组通过调整步幅长度和步频来调节步态速度，与对照组相似，而非线性FGD参与者调整步幅长度，但步频调整与对照组不同。与线性FGD组相比，非线性FGD组的步态干扰更大、姿势控制更差且跌倒恐惧更大。对SLCrel的研究为FGD中发现的步态变化的潜在机制带来了新的见解。研究结果表明，在较轻的FGD中步幅长度调节受到破坏，但随着疾病恶化，步频控制也变得紊乱，导致步幅长度与步频之间的关系破裂。
