Neuroscience Research Australia, Sydney, Australia; School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia.
Neuroscience Research Australia, Sydney, Australia; School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia.
Parkinsonism Relat Disord. 2018 Feb;47:32-38. doi: 10.1016/j.parkreldis.2017.11.340. Epub 2017 Nov 22.
Decline in the ability to take effective steps and to adapt gait, particularly under challenging conditions, may be important reasons why people with Parkinson's disease (PD) have an increased risk of falling. This study aimed to determine the extent of stepping and gait adaptability impairments in PD individuals as well as their associations with PD symptoms, cognitive function and previous falls.
Thirty-three older people with PD and 33 controls were assessed in choice stepping reaction time, Stroop stepping and gait adaptability tests; measurements identified as fall risk factors in older adults.
People with PD had similar mean choice stepping reaction times to healthy controls, but had significantly greater intra-individual variability. In the Stroop stepping test, the PD participants were more likely to make an error (48 vs 18%), took 715 ms longer to react (2312 vs 1517 ms) and had significantly greater response variability (536 vs 329 ms) than the healthy controls. People with PD also had more difficulties adapting their gait in response to targets (poorer stepping accuracy) and obstacles (increased number of steps) appearing at short notice on a walkway. Within the PD group, higher disease severity, reduced cognition and previous falls were associated with poorer stepping and gait adaptability performances.
People with PD have reduced ability to adapt gait to unexpected targets and obstacles and exhibit poorer stepping responses, particularly in a test condition involving conflict resolution. Such impaired stepping responses in Parkinson's disease are associated with disease severity, cognitive impairment and falls.
行动能力下降以及步态适应能力下降（尤其是在具有挑战性的条件下），可能是导致帕金森病（PD）患者跌倒风险增加的重要原因。本研究旨在确定 PD 患者在步态适应性方面的步态适应性受损程度，以及这些受损与 PD 症状、认知功能和既往跌倒之间的关系。
对 33 名老年 PD 患者和 33 名健康对照者进行了选择步反应时间、斯特鲁普步和步态适应性测试；这些测试被确定为老年人跌倒的风险因素。
PD 患者的平均选择步反应时间与健康对照组相似，但个体内变异性显著增加。在斯特鲁普步测试中，PD 患者更有可能犯错（48%对 18%），反应时间延长 715 毫秒（2312 毫秒对 1517 毫秒），反应变异性显著增加（536 毫秒对 329 毫秒）。PD 患者在应对突然出现的目标（步态准确性下降）和障碍物（步数增加）时，也更难以适应他们的步态。在 PD 组中，疾病严重程度较高、认知能力下降和既往跌倒与较差的步态适应性和步态适应性表现有关。
PD 患者适应突发目标和障碍物的能力下降，并且表现出较差的步态反应，尤其是在涉及冲突解决的测试条件下。帕金森病患者的这种步态反应受损与疾病严重程度、认知障碍和跌倒有关。
