Biomechanics Laboratory, College of Health Sciences, Dong-A University, Busan, Republic of Korea.
Department of Neurology, School of Medicine, Dong-A University, Busan, Republic of Korea.
Gait Posture. 2018 Mar;61:320-324. doi: 10.1016/j.gaitpost.2018.01.034. Epub 2018 Feb 1.
Freezing of gait (FOG) is a major risk factor for falls and fall-related injuries in patients with Parkinson's disease (PD). The characteristics of gait in PD patients with FOG have been studied but remain controversial. To investigate gait characteristics of FOG in PD, this study analyzed the forward and backward walking of patients with PD. Twenty-six patients with PD were recruited [age: 71.0 ± 6.2 years, Hoehn and Yahr stage: 2-3 (median 2.5)]. Based on responses to the New Freezing of Gait Questionnaire, we classified patients into either the "freezer" or "non-freezer" group. Spatiotemporal and kinematic analyses of forward and backward walking were completed using a three-dimensional motion analysis system over an 8 m walkway in the defined "off" state. There was no difference in demographic and clinical characteristics between the freezers (n = 10) and non-freezers (n = 16). Analysis of forward walking revealed no between-group differences, except for faster walking speed among the non-freezers. During backward walking, the freezers exhibited slower walking speed, shorter stride length, and increased asymmetry of step length. Kinematic analysis of backward walking revealed smaller range of motion in hip and ankle joints and lower step height in freezers. Further investigations of backward walking might expand our understanding of the pathophysiology of FOG in patients with PD.
冻结步态（FOG）是帕金森病（PD）患者跌倒和跌倒相关损伤的主要危险因素。FOG 患者的步态特征已被研究，但仍存在争议。为了研究 PD 患者 FOG 的步态特征，本研究分析了 PD 患者的前后行走。招募了 26 名 PD 患者[年龄：71.0±6.2 岁，Hoehn 和 Yahr 分期：2-3 期（中位数 2.5）]。根据新冻结步态问卷的回答，我们将患者分为“冻结者”或“非冻结者”组。在规定的“关”状态下，使用三维运动分析系统在 8m 步行道上完成前后行走的时空和运动学分析。冻结者（n=10）和非冻结者（n=16）在人口统计学和临床特征方面没有差异。在向前行走的分析中，除了非冻结者的行走速度较快外，两组之间没有差异。在向后行走时，冻结者的行走速度较慢，步长较短，步长不对称性增加。向后行走的运动学分析显示冻结者髋关节和踝关节的活动范围较小，步高较低。进一步研究向后行走可能会扩展我们对 PD 患者 FOG 病理生理学的理解。
