Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Hebrew University Hadassah medical school, Jerusalem, Israel.
Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
PLoS One. 2018 Apr 26;13(4):e0196599. doi: 10.1371/journal.pone.0196599. eCollection 2018.
Progressive ataxic gait is a common symptom in individuals with Familial Dysautonomia (FD). At least 50% of adults with FD require assistance with walking. Our aims were to describe the medical condition of individuals with FD (ii) compare their gait characteristics to healthy individuals, and (iii) assess correlations between gait measures, presence of unstable gait pattern and frequency of falls.
Twelve subjects with FD (7 males, age 25.3±10.6 years) and 16 healthy participants (6 males, age 35.9±11.9 years) were recruited. Gait kinematics, gait symmetry, dynamic muscle activity, and foot deep vibration sensation were recorded.
Ataxic gait degrees were: severe (6 out of 12), moderate (4 out of 12) and low (2 out of 12). The number of falls correlated with base width asymmetry. Crouch gait was noted in 3 out of 12 of the subjects.
In-depth quantitative gait analysis of individuals with FD revealed ataxic gait. The ataxic pattern might be a result of combined neurological deficiencies and osseous deformities. Increasing the base of support of patients with FD might increase the symmetry of the base width during gait and decrease the number of falls. Additionally, perturbation treatment and dynamic balance exercises may be recommended in order to improve compensatory strategies. Future investigation of this population should include quantification of osseous rotations of the lower limb in order to fully understand its effect on their gait pattern and falls.
进行性共济失调步态是家族性自主神经异常(FD)患者的常见症状。至少 50%的 FD 成人需要辅助行走。我们的目的是描述 FD 患者的身体状况(ii)将他们的步态特征与健康个体进行比较,以及(iii)评估步态测量、不稳定步态模式的存在和跌倒频率之间的相关性。
招募了 12 名 FD 患者(7 名男性,年龄 25.3±10.6 岁)和 16 名健康参与者(6 名男性,年龄 35.9±11.9 岁)。记录了步态运动学、步态对称性、动态肌肉活动和足部深部振动感觉。
共济失调步态程度为:严重(12 人中 6 人)、中度(12 人中 4 人)和低度(12 人中 2 人)。跌倒次数与基底宽度不对称有关。12 名受试者中有 3 名出现蹲伏步态。
对 FD 患者进行深入的定量步态分析显示出共济失调步态。这种共济失调模式可能是神经功能缺陷和骨骼畸形的综合结果。增加 FD 患者的支撑基础可能会增加步态中基底宽度的对称性,并减少跌倒次数。此外,建议进行扰动治疗和动态平衡练习,以改善代偿策略。对该人群的进一步研究应包括量化下肢骨骼旋转,以全面了解其对步态模式和跌倒的影响。