College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Parkinsonism Relat Disord. 2018 Aug;53:58-63. doi: 10.1016/j.parkreldis.2018.04.032. Epub 2018 May 1.
Freezing of gait (FOG) is a debilitating, late motor complication of Parkinson's disease (PD) that occurs in 50-80% of patients. Gait freezing significantly worsens quality of life by decreasing mobility and increasing falls. Studies have shown that patients with episodic freezing episodes also have deficits in continuous gait. We evaluated whether there was an objective gait correlate to the increased stumbling reported by many patients with gait freezing.
PD subjects and healthy controls (HC) were enrolled after IRB approval. Subjects with more than 1 fall/day or a Montreal Cognitive Assessment score <10 were excluded. Subjects walked at their normal pace, 8 lengths of a 20 × 4 foot pressure-sensor mat. Data was collected and analyzed using PKMAS software (Protokinetics) and statistical analysis performed using SPSS 22 (IBM).
72 age matched subjects (22 PD FOG, 27 PD no-FOG, and 23 HC) were enrolled. Disease duration and Hoehn & Yahr scores were not significantly different between the PD groups. Mean dimensions of foot strike were not significantly different between groups, but PD FOG subjects had increased step-to-step variability in foot strike as measured by the percent coefficient of variation (%CV) in foot strike length compared to PD no-FOG and HC, independent of stride velocity. In PD no-FOG subjects, fallers also had higher variability in foot strike length compared to non-fallers.
PD subjects with FOG had increased variability in foot strike suggesting that in addition to stride length variability, foot strike variability could contribute to imbalance leading to falls.
冻结步态（FOG）是帕金森病（PD）的一种致残性晚期运动并发症，发生在 50-80%的患者中。步态冻结通过降低活动能力和增加跌倒显著降低生活质量。研究表明，有间歇性冻结发作的患者在连续步态方面也存在缺陷。我们评估了是否存在与许多步态冻结患者报告的绊倒增加有关的客观步态相关性。
在 IRB 批准后，招募 PD 受试者和健康对照（HC）。排除每天跌倒超过 1 次或蒙特利尔认知评估评分<10 的患者。受试者以正常速度行走，8 次 20×4 英尺压力传感器垫。使用 PKMAS 软件（Protokinetics）收集和分析数据，并使用 SPSS 22（IBM）进行统计分析。
共纳入 72 名年龄匹配的受试者（22 名 PD FOG，27 名 PD 无 FOG 和 23 名 HC）。PD 组之间的疾病持续时间和 Hoehn & Yahr 评分无显著差异。组间足触地的平均尺寸无显著差异，但 PD FOG 受试者与 PD 无 FOG 和 HC 相比，足触地长度的步间变异性增加，以足触地长度的百分比变异系数（%CV）衡量，而与步速无关。在 PD 无 FOG 受试者中，跌倒者的足触地长度也比非跌倒者更具变异性。
FOG 的 PD 受试者的足触地变异性增加，这表明除了步长变异性外，足触地变异性可能会导致平衡失调导致跌倒。
