Sutter Ellen N, Seidler Katie J, Duncan Ryan P, Earhart Gammon M, McNeely Marie E
Program in Physical Therapy, Washington University School of Medicine, St. Louis, USA.
J Rehabil Med. 2017 Jun 28;49(6):505-511. doi: 10.2340/16501977-2238.
To evaluate the relationship between spatiotemporal parameters of forward and backward gait and quality of compensatory stepping responses in forward and backward directions in people with Parkinson's disease with and without freezing of gait.
Cross-sectional analysis.
A total of 111 individuals with mild to moderate Parkinson's disease.
Forward and backward gait velocity and step length were evaluated using a GAITRite walkway. Forward and backward postural responses were evaluated using items from the Mini Balance Evaluation Systems Test and the Movement Disorders Society Unified Parkinson Disease Rating Scale motor subsection. Relationships between gait and postural responses were examined for the full sample and for sub-groups with and without freezing of gait.
There were significant (p < 0.05) low to moderate correlations between postural responses and gait overall. Correlations were similar in the freezer and non-freezer sub-groups. Freezers performed worse than non-freezers on all gait parameters and backward postural response items (p < 0.05).
Low to moderate relationships between gait and postural responses indicate the complexity of postural control and the potential involvement of different neural circuitry across these tasks. Better understanding of the relationships between gait and postural deficits in Parkinson's disease may inform the future development of targeted interventions to address these impairments.
评估帕金森病患者存在和不存在冻结步态时,向前和向后步态的时空参数与向前和向后方向代偿性步幅反应质量之间的关系。
横断面分析。
共111例轻度至中度帕金森病患者。
使用GAITRite步道评估向前和向后步态速度及步长。使用简易平衡评估系统测试和运动障碍协会统一帕金森病评定量表运动部分的项目评估向前和向后姿势反应。对整个样本以及存在和不存在冻结步态的亚组检查步态与姿势反应之间的关系。
姿势反应与总体步态之间存在显著(p < 0.05)的低至中度相关性。冻结步态亚组和非冻结步态亚组的相关性相似。在所有步态参数和向后姿势反应项目上,存在冻结步态者比不存在冻结步态者表现更差(p < 0.05)。
步态与姿势反应之间的低至中度关系表明姿势控制的复杂性以及这些任务中不同神经回路的潜在参与。更好地理解帕金森病步态与姿势缺陷之间的关系可能为未来针对性干预措施的开发提供参考,以解决这些损伤问题。