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身体高度降低是帕金森病中脊柱后凸畸形的特征。

Body height loss characterizes camptocormia in Parkinson's disease.

机构信息

Department of Neurology and Clinical Neurophysiology, Centre for Parkinson's Disease and Movement Disorders, Schön Klinik München Schwabing, Parzivalplatz 4, 80804, Munich, Germany.

Department of Neurology, Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany.

出版信息

J Neural Transm (Vienna). 2018 Oct;125(10):1473-1480. doi: 10.1007/s00702-018-1912-2. Epub 2018 Aug 7.

Abstract

Axial deformities such as camptocormia or Pisa syndrome in people with Parkinson's disease (PwP) are poorly understood. The scarcity of information may result from the shortage of reliable and responsive evaluation instruments. We evaluated the body height loss (BHL) as a new measure for PwP with axial deformities. 50 PwP with axial deformity defined by an UPDRS item 28 value of at least 2 were included in this mono-center study. We measured body height while lying supine and after 1 min of standing, providing a percentage value of BHL, and compared this measure to other clinical variables. BHL depended on the Hoehn and Yahr clinical stage and correlated with clinical scales for function and mobility, but not with timely measures of the axial disorder such as age at diagnosis or duration of disease. ANOVA showed that only lumbar flexion explained the variability of BHL (F = 21.0, p < 0.0001), but not kyphosis (F = 0.4, p = 0.74) or lateroflexion (F = 0.6, p = 0.6). Re-test reliability of BHL was good with к = 0.76 (p < 0.0001). BHL resulted from the lumbar spine and the hip joint and not from the thoracic spine or lateroflexion. This observation conforms to the concept of upper-type and lower-type camptocormia with only the latter leading to a BHL. The assessment of the BHL is shown to be a well defined, easy to perform, and reliable measure for the clinical evaluation of lower-type camptocormia.

摘要

帕金森病患者(PwP)的轴向畸形,如驼背或比萨综合征,人们对此了解甚少。信息的缺乏可能是由于缺乏可靠和敏感的评估工具所致。我们评估了身体高度损失(BHL)作为一种评估伴有轴向畸形的 PwP 的新方法。本单中心研究纳入了 50 名符合 UPDRS 项目 28 评分至少 2 分的伴有轴向畸形的 PwP。我们测量了患者仰卧位和站立 1 分钟后的身高,提供了 BHL 的百分比值,并将该指标与其他临床变量进行了比较。BHL 取决于 Hoehn 和 Yahr 临床分期,并与功能和移动性的临床量表相关,但与轴向障碍的及时测量无关,如诊断时的年龄或疾病持续时间。方差分析显示,只有腰椎前凸度可以解释 BHL 的变异性(F=21.0,p<0.0001),而不是后凸(F=0.4,p=0.74)或侧弯(F=0.6,p=0.6)。BHL 的重测信度良好,к=0.76(p<0.0001)。BHL 源于腰椎和髋关节,而不是胸椎或侧弯。这一观察结果符合上型和下型驼背的概念,只有后者才会导致 BHL。BHL 的评估被证明是一种定义明确、易于执行且可靠的方法,可用于评估下型驼背。

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