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步行训练干预可改善轻至中度帕金森病患者的步态和轴性症状。

Polestriding Intervention Improves Gait and Axial Symptoms in Mild to Moderate Parkinson Disease.

作者信息

Krishnamurthi Narayanan, Shill Holly, O'Donnell Darolyn, Mahant Padma, Samanta Johan, Lieberman Abraham, Abbas James

机构信息

Center for Adaptive Neural Systems, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ; Muhammad Ali Parkinson Center, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ.

Banner Sun Health Research Institute, Sun City, AZ.

出版信息

Arch Phys Med Rehabil. 2017 Apr;98(4):613-621. doi: 10.1016/j.apmr.2016.10.002. Epub 2016 Oct 27.

Abstract

OBJECTIVE

To evaluate the effects of 12-week polestriding intervention on gait and disease severity in people with mild to moderate Parkinson disease (PD).

DESIGN

A-B-A withdrawal study design.

SETTING

Outpatient movement disorder center and community facility.

PARTICIPANTS

Individuals (N=17; 9 women [53%] and 8 men [47%]; mean age, 63.7±4.9y; range, 53-72y) with mild to moderate PD according to United Kingdom brain bank criteria with Hoehn & Yahr score ranging from 2.5 to 3.0 with a stable medication regimen and ability to tolerate "off" medication state.

INTERVENTIONS

Twelve-week polestriding intervention with 12-week follow-up.

MAIN OUTCOME MEASURES

Gait was evaluated using several quantitative temporal, spatial, and variability measures. In addition, disease severity was assessed using clinical scales such as Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn & Yahr scale, and Parkinson's Disease Questionnaire-39.

RESULTS

Step and stride lengths, gait speed, and step-time variability were improved significantly (P<.05) because of 12-week polestriding intervention. Also, the UPDRS motor score, the UPDRS axial score, and the scores of UPDRS subscales on walking and balance improved significantly after the intervention.

CONCLUSIONS

Because increased step-time variability and decreased step and stride lengths are associated with PD severity and an increased risk of falls in PD, the observed improvements suggest that regular practice of polestriding may reduce the risk of falls and improve mobility in people with PD.

摘要

目的

评估为期12周的健步走干预对轻至中度帕金森病(PD)患者步态及疾病严重程度的影响。

设计

A - B - A撤药研究设计。

地点

门诊运动障碍中心及社区设施。

参与者

根据英国脑库标准诊断为轻至中度PD的个体(N = 17;9名女性[53%]和8名男性[47%];平均年龄63.7±4.9岁;范围53 - 72岁),Hoehn & Yahr评分在2.5至3.0之间,药物治疗方案稳定且能耐受“关”期药物状态。

干预措施

为期12周的健步走干预及12周的随访。

主要观察指标

使用多种定量的时间、空间和变异性指标评估步态。此外,使用统一帕金森病评定量表(UPDRS)、Hoehn & Yahr量表和帕金森病问卷 - 39等临床量表评估疾病严重程度。

结果

由于为期12周的健步走干预,步长和步幅、步态速度及步时变异性均有显著改善(P <.05)。此外,干预后UPDRS运动评分、UPDRS轴性评分以及UPDRS行走和平衡分量表评分均有显著改善。

结论

由于步时变异性增加以及步长和步幅减小与PD严重程度及PD患者跌倒风险增加相关,观察到的改善表明,定期进行健步走可能降低PD患者的跌倒风险并改善其活动能力。

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