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早期帕金森病的步态分析及临床关联

Gait analysis and clinical correlations in early Parkinson's disease.

作者信息

Pistacchi M, Gioulis M, Sanson F, De Giovannini E, Filippi G, Rossetto F, Zambito Marsala S

出版信息

Funct Neurol. 2017 Jan/Mar;32(1):28-34. doi: 10.11138/fneur/2017.32.1.028.

Abstract

The aim of our study was to identify and quantify spatiotemporal and kinematic gait parameters obtained by 3D gait analysis (GA) in a group of Parkinson's disease (PD) patients compared with healthy subjects in order to investigate whether early PD patients could present an abnormal gait pattern. Forty-four patients affected by early-stage PD compared with a control group were analyzed. All participants were evaluated with 3D GA in the gait laboratory. The greatest significance in temporal parameters was found in cadence (102.46 ± 13.17 steps/min in parkinsonian patients vs 113.84 ± 4.30 steps/min in control subjects), followed by stride duration (1.19 ± 0.18 seconds right limb and 1.19 ± 0.19 seconds left limb in PD patients vs 0.426 ± 0.16 seconds right limb and 0.429 ± 0.23 seconds left limb in normal subjects) and stance duration. Marked differences were also found in the swing phase and in swing duration (p<0.05), while the stance phase was not significantly different in patients compared with healthy subjects. A statistically different velocity in PD patients (0.082 ± 0.29 m/s) vs healthy subjects (1.33 ± 0.06 m/s) was shown by spatial parameter analysis. Step width, stride length and swing velocity were highly significant parameters, as was average velocity. Our study highlighted some distinguishing characteristics of gait in early PD. Ambulation disorders may be present in the early stage of PD and their detection allows for early medical treatment and possible rehabilitation.

摘要

我们研究的目的是识别和量化一组帕金森病(PD)患者通过三维步态分析(GA)获得的时空和运动学步态参数,并与健康受试者进行比较,以调查早期PD患者是否会呈现异常步态模式。对44例早期PD患者与一个对照组进行了分析。所有参与者均在步态实验室接受三维GA评估。在时间参数方面,步频差异最为显著(帕金森病患者为102.46±13.17步/分钟,对照组为113.84±4.30步/分钟),其次是步幅持续时间(PD患者右下肢为1.19±0.18秒,左下肢为1.19±0.19秒;正常受试者右下肢为0.426±0.16秒,左下肢为0.429±0.23秒)和站立持续时间。在摆动期和摆动持续时间方面也发现了显著差异(p<0.05),而与健康受试者相比,患者的站立期无显著差异。空间参数分析显示,PD患者(0.082±0.29米/秒)与健康受试者(1.33±0.06米/秒)的速度在统计学上存在差异。步宽、步幅长度和摆动速度以及平均速度都是高度显著的参数。我们的研究突出了早期PD患者步态的一些显著特征。行走障碍可能在PD早期就存在,对其进行检测有助于早期医疗治疗和可能的康复。

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