帕金森病患者的最大步长测试表现：一项横断面研究。
Maximum Step Length Test Performance in People With Parkinson Disease: A Cross-sectional Study.
机构信息
Program in Physical Therapy, Washington University School of Medicine in Saint Louis, Missouri (R.P.D., M.E.M., G.M.E.); Department of Neurology, Washington University School of Medicine in Saint Louis, Missouri (R.P.D., M.E.M., G.M.E.); and Department of Neuroscience, Washington University School of Medicine in Saint Louis, Missouri (G.M.E.).
出版信息
J Neurol Phys Ther. 2017 Oct;41(4):215-221. doi: 10.1097/NPT.0000000000000201.
BACKGROUND AND PURPOSE
The Maximum Step Length Test (MSLT), a measure of one's capacity to produce a large step, has been studied in older adults, but not in people with Parkinson disease (PD). We characterized performance and construct validity of the MSLT in PD.
METHODS
Forty participants (mean age: 65.12 ± 8.20 years; 45% female) with idiopathic PD completed the MSLT while "OFF" and "ON" anti-PD medication. Construct validity was investigated by examining relationships between MSLT and measures of motor performance. The following measures were collected: Mini-Balance Evaluation Systems Test (Mini-BESTest), Activities-specific Balance Confidence (ABC) scale, gait velocity, 6-minute walk test (6MWT), Movement Disorder Society-Unified Parkinson Disease Rating Scale subsection III (MDS-UPDRS III), and Timed Up and Go (TUG) test. A repeated-measures analysis of variance tested for main effects of medication and stepping direction and the interaction between the 2. Pearson or Spearman correlations were used to assess the relationships between MSLT and motor performance measures (α = 0.05).
RESULTS
Regardless of medication status, participants stepped further in the forward direction compared with the backward and lateral directions (P < 0.001). Participants increased MSLT performance when ON-medication compared with OFF-medication (P = 0.004). Regardless of medication status, MSLT was moderately to strongly related to Mini-BESTest, TUG, and 6MWT.
DISCUSSION AND CONCLUSIONS
People with PD stepped furthest in the forward direction when performing the MSLT. Increased MSLT performance was observed in the ON-medication state compared with OFF-medication; however, the small increase may not be clinically meaningful. Given the relationships between the MSLT and the Mini-BESTest, 6MWT, and TUG, MSLT performance appears to be associated with balance and gait hypokinesia in people with PD.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A186).
背景与目的
最大步长测试（MSLT）是衡量一个人大步前进能力的指标，已在老年人中进行了研究，但尚未在帕金森病（PD）患者中进行研究。我们对 PD 患者的 MSLT 表现和结构有效性进行了描述。
方法
40 名参与者（平均年龄：65.12 ± 8.20 岁；45%为女性）在“关闭”和“开启”抗 PD 药物状态下完成了 MSLT。通过检查 MSLT 与运动表现测量之间的关系来研究结构有效性。收集了以下测量值：Mini-Balance Evaluation Systems Test（Mini-BESTest）、活动特异性平衡信心（ABC）量表、步态速度、6 分钟步行测试（6MWT）、运动障碍协会统一帕金森病评定量表第 III 部分（MDS-UPDRS III）和计时起立行走测试（TUG）。重复测量方差分析测试了药物和步长方向的主要影响以及两者之间的相互作用。Pearson 或 Spearman 相关性用于评估 MSLT 与运动表现测量之间的关系（α=0.05）。
结果
无论药物状态如何，参与者向前方向的步长都比向后和侧向方向更远（P<0.001）。与停药相比，参与者在服药时的 MSLT 表现有所提高（P=0.004）。无论药物状态如何，MSLT 与 Mini-BESTest、TUG 和 6MWT 均呈中度至强相关。
讨论和结论
PD 患者在执行 MSLT 时向前迈出的距离最远。与停药相比，在服药状态下观察到 MSLT 表现增加；然而，这种小的增加可能没有临床意义。鉴于 MSLT 与 Mini-BESTest、6MWT 和 TUG 之间的关系，MSLT 表现似乎与 PD 患者的平衡和步态运动迟缓有关。（见视频，补充数字内容 1，http://links.lww.com/JNPT/A186）
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