Ishii Mitsuaki, Okuyama Kohei
Department of Physical Therapy, School of Health Science, Bukkyo University: 7 Nishinokyo Higashi-toganoocho, Nakagyo-ku, Kyoto 604-8418, Japan.
Department of Physical Therapy, Second Ueda Rehabilitation Clinic, Japan.
J Phys Ther Sci. 2017 Dec;29(12):2151-2156. doi: 10.1589/jpts.29.2151. Epub 2017 Dec 7.
[Purpose] Parkinson's disease (PD) patients often freeze in actual daily living but seldom in clinical setting. This study aimed to identify the factors contributing to freezing of gait (FOG). [Subjects and Methods] The participants included 28 adults with PD. Principal component analysis was used to investigate the characteristics of 14 common FOG situations adopted from previous studies. Cluster analysis classified the subjects into four groups. Kruskal-Wallis test was performed to compare the PD Questionnaire-39 mobility dimension between the groups. [Results] The major variables of the first principal component in 14 FOG situations were unfamiliar places, unpredictable schedule changes, entering an automatic door, when another person suddenly crossed, and change in the walking surface. These situations were unrelated to the second principal component. Getting on/off a public transport and crowded places were major variables for the second principal component, and related to both the first and second principal components. Although fatigue was the most frequent FOG situation, not all principal components were influenced. The values of the PD Questionnaire-39 revealed significant differences between the groups. [Conclusion] Actual FOG situations may be categorized into (1) task complexity, (2) both task complexity and emotional factors, and (3) fatigue as decreased attentional resources.
[目的]帕金森病(PD)患者在实际日常生活中经常出现冻结现象,但在临床环境中很少出现。本研究旨在确定导致步态冻结(FOG)的因素。[对象与方法]参与者包括28名成年PD患者。主成分分析用于研究从先前研究中采用的14种常见FOG情况的特征。聚类分析将受试者分为四组。进行Kruskal-Wallis检验以比较各组之间的帕金森病问卷-39运动维度。[结果]14种FOG情况中第一主成分的主要变量是不熟悉的地方、不可预测的日程变化、进入自动门、当另一个人突然穿过时以及行走表面的变化。这些情况与第二主成分无关。上下公共交通工具和拥挤的地方是第二主成分的主要变量,并且与第一和第二主成分都相关。尽管疲劳是最常见的FOG情况,但并非所有主成分都受到影响。帕金森病问卷-39的值在各组之间显示出显著差异。[结论]实际的FOG情况可分为(1)任务复杂性,(2)任务复杂性和情绪因素两者,以及(3)作为注意力资源减少的疲劳。