Penn I-Wen, Sung Wen-Hsu, Lin Pei-Hsin, Wang Jia-Chi, Chuang Eric, Chuang Tien-Yow, Kuo Chia-Yu
School of Medicine.
Department of Physical Medicine and Rehabilitation, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City.
Int J Rehabil Res. 2019 Jun;42(2):126-132. doi: 10.1097/MRR.0000000000000334.
Few studies have explored the potential of gait analysis and training in nonmotorized treadmill (NMT) in Parkinson's disease (PD) patients. We investigated (a) the walking strategy adopted by patients with PD on NMT and (b) how balance may influence spatiotemporal gait parameters. We enrolled 12 patients with PD of modified Hoehn and Yahr stage 2-3 and 13 nondisabled individuals as controls. All participants were evaluated using Tinetti's performance oriented mobility assessment scale, freezing of gait questionnaire, modified falls efficacy scale, and the timed up and go test. They were asked to ambulate with comfortable and maximal speeds on the NMT. The gait parameters acquired on the NMT included walking speed, cadence (CAD), step length, and vertical ground reaction force, which were calculated for intragroup and intergroup comparisons. The PD group took on with higher contribution of CAD and less contribution of step length to increase walking speed as compared with control group. The postural stability is correlated significantly positively to the CAD at the setting of maximal speed in the PD group. Moreover, a significantly lower ratio of vertical ground reaction force/body weight was noted in the PD group during both comfortable and maximal walking speeds compared with the nondisabled controls. Our study outcomes clearly support the perceived benefits of NMT to differentiate spatiotemporal gait parameters between PD and controls. NMT may potentially be useful to evaluate the recovery of physical activities in PD receiving medications and/or rehabilitation.
很少有研究探讨非电动跑步机(NMT)在帕金森病(PD)患者中进行步态分析和训练的潜力。我们调查了(a)帕金森病患者在非电动跑步机上采用的行走策略,以及(b)平衡如何影响时空步态参数。我们招募了12名改良Hoehn和Yahr分期为2-3期的帕金森病患者以及13名无残疾个体作为对照。所有参与者均使用Tinetti的以表现为导向的移动性评估量表、步态冻结问卷、改良跌倒效能量表以及计时起立行走测试进行评估。要求他们在非电动跑步机上以舒适速度和最大速度行走。在非电动跑步机上获取的步态参数包括行走速度、步频(CAD)、步长和垂直地面反作用力,用于组内和组间比较。与对照组相比,帕金森病组在增加行走速度时步频的贡献更大,步长的贡献更小。在帕金森病组中,最大速度时的姿势稳定性与步频显著正相关。此外,与无残疾对照组相比,帕金森病组在舒适行走速度和最大行走速度时垂直地面反作用力与体重的比值均显著降低。我们的研究结果明确支持非电动跑步机在区分帕金森病患者和对照组的时空步态参数方面的显著益处。非电动跑步机可能有助于评估接受药物治疗和/或康复治疗的帕金森病患者身体活动能力的恢复情况。