Pyo Seon Jong, Kim Hanjun, Kim Il Soo, Park Young-Min, Kim Mi-Jung, Lee Hye Mi, Koh Seong-Beom
Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Department of Neurology, Korea SU Hospital, Seoul, Korea.
J Mov Disord. 2017 Sep;10(3):140-144. doi: 10.14802/jmd.17041. Epub 2017 Aug 31.
Gait disturbance is the main factor contributing to a negative impact on quality of life in patients with Huntington's disease (HD). Understanding gait features in patients with HD is essential for planning a successful gait strategy. The aim of this study was to investigate temporospatial gait parameters in patients with HD compared with healthy controls.
We investigated 7 patients with HD. Diagnosis was confirmed by genetic analysis, and patients were evaluated with the Unified Huntington's Disease Rating Scale (UHDRS). Gait features were assessed with a gait analyzer. We compared the results of patients with HD to those of 7 age- and sex-matched normal controls.
Step length and stride length were decreased and base of support was increased in the HD group compared to the control group. In addition, coefficients of variability for step and stride length were increased in the HD group. The HD group showed slower walking velocity, an increased stance/swing phase in the gait cycle and a decreased proportion of single support time compared to the control group. Cadence did not differ significantly between groups. Among the UHDRS subscores, total motor score and total behavior score were positively correlated with step length, and total behavior score was positively correlated with walking velocity in patients with HD.
Increased variability in step and stride length, slower walking velocity, increased stance phase, and decreased swing phase and single support time with preserved cadence suggest that HD gait patterns are slow, ataxic and ineffective. This study suggests that quantitative gait analysis is needed to assess gait problems in HD.
步态障碍是对亨廷顿舞蹈症(HD)患者生活质量产生负面影响的主要因素。了解HD患者的步态特征对于制定成功的步态策略至关重要。本研究的目的是调查HD患者与健康对照者的时空步态参数。
我们调查了7例HD患者。通过基因分析确诊,并用统一亨廷顿舞蹈症评定量表(UHDRS)对患者进行评估。使用步态分析仪评估步态特征。我们将HD患者的结果与7名年龄和性别匹配的正常对照者的结果进行了比较。
与对照组相比,HD组的步长和步幅减小,支撑面增宽。此外,HD组步长和步幅的变异系数增加。与对照组相比,HD组的步行速度较慢,步态周期中的站立/摆动期增加,单支撑时间比例降低。两组之间的步频无显著差异。在UHDRS子评分中,HD患者的总运动评分和总行为评分与步长呈正相关,总行为评分与步行速度呈正相关。
步长和步幅的变异性增加、步行速度减慢、站立期增加、摆动期和单支撑时间减少而步频保持不变,表明HD步态模式缓慢、共济失调且无效。本研究表明,需要进行定量步态分析来评估HD患者的步态问题。