Rennie Linda, Löfgren Niklas, Moe-Nilssen Rolf, Opheim Arve, Dietrichs Espen, Franzén Erika
Sunnaas Rehabilitation Hospital, Research Department, Nesodden, Norway.
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden; Karolinska University Hospital, Function Allied Health Professionals, Function Area Occupational Therapy and Physiotherapy, Stockholm, Sweden.
Gait Posture. 2018 May;62:505-509. doi: 10.1016/j.gaitpost.2018.04.011. Epub 2018 Apr 14.
Step-to-step variability is a marker of reduced motor control and a frequently studied outcome measure in neurodegenerative disorders such as Parkinson's disease (PD) as compared to healthy older adults (HOA). To challenge motor control of gait, walking should be tested at different gait speeds. Good reliability is essential, and gait variability estimates show good reproducibility when sampled at normal gait speed. The aim was therefore to investigate if gait variability could be reliably sampled at slow and fast speeds for individuals with PD and HOA by evaluating test-retest reliability.
29 (14 males) subjects with idiopathic PD, Hoehn &Yahr 2 (n = 18) and 3, ≥ 60 years, and 25 age matched HOAwere included. Spatiotemporal gait data was collected (GAITRite) during slow, normal, and fast walking on two occasions.
Measurement error was lowest for gait variability estimates based on 40 steps in both groups. This was true across all speeds in HOA, but only for normal and fast gait speeds in the PD cohort. Due to increased homogeneity in the variability estimates intraclass correlation coefficients (ICC) were low for HOA, except for step width variability. In the PD cohort ICCs were good to excellent for temporal- and step width gait variability across speeds.
HOA demonstrated reliable gait variability estimates across all speeds, whereas Individuals with PD were reliable at normal and fast gait speeds only Estimates should be based on at least 40 steps. Step width variability was overall the most reliable variable across groups and speed conditions.
与健康老年人（HOA）相比，步步间变异性是运动控制能力下降的一个指标，也是帕金森病（PD）等神经退行性疾病中经常研究的一项结果指标。为了挑战步态的运动控制，应在不同的步态速度下测试步行。良好的可靠性至关重要，并且当以正常步态速度采样时，步态变异性估计显示出良好的可重复性。因此，本研究旨在通过评估重测信度，探讨PD患者和HOA个体在慢速和快速行走时步态变异性是否能被可靠地采样。
纳入29名（14名男性）特发性PD患者，Hoehn&Yahr分级为2级（n = 18）和3级，年龄≥60岁，以及25名年龄匹配的HOA。在慢速、正常和快速行走时，分两次收集时空步态数据（GAITRite）。
两组中基于40步的步态变异性估计的测量误差最低。在HOA中，所有速度下均如此，但在PD队列中，仅正常和快速步态速度下如此。由于变异性估计中的同质性增加，HOA的组内相关系数（ICC）较低，但步宽变异性除外。在PD队列中，不同速度下的时间和步宽步态变异性的ICC良好至优秀。
HOA在所有速度下均表现出可靠的步态变异性估计，而PD个体仅在正常和快速步态速度下可靠。估计应基于至少40步。步宽变异性总体上是各组和速度条件下最可靠的变量。
