Geerse Daphne J, Roerdink Melvyn, Marinus Johan, van Hilten Jacobus J
Department of Neurology, Leiden University Medical Center, Leiden, Netherlands.
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
Front Neurol. 2018 Dec 12;9:1096. doi: 10.3389/fneur.2018.01096. eCollection 2018.
In people with Parkinson's disease (PD) many aspects of walking ability deteriorate with advancing disease. Clinical tests typically evaluate single aspects of walking and to a lesser extent assess more complex walking tasks involving a combination of the three key aspects of walking ability (i.e., generating stepping, maintaining postural equilibrium, adapting walking). The Interactive Walkway allows for assessing more complex walking tasks to address features that are relevant for daily life walking of patients, including adaptive walking and dual-task walking. To evaluate the expected added value of Interactive Walkway assessments in people with PD, we first evaluated its known-groups validity for outcome measures of unconstrained walking, adaptive walking and dual-task walking. Subsequently, these outcome measures were related to commonly used clinical test scores. Finally, we evaluated the expected added value of these outcomes over clinical tests scores in discriminating people with PD with and without freezing of gait. Interactive Walkway outcome measures showed significant differences between freezers, non-freezers and healthy controls, in expected directions. Most Interactive Walkway outcome measures were not or at best moderately correlated with clinical test scores. Finally, Interactive Walkway outcome measures of adaptive walking slightly better discriminated freezers from non-freezers than clinical tests scores. We confirmed the added value of Interactive Walkway assessments, which provides a comprehensive evaluation of walking ability incorporating features of its three key aspects. Future studies are warranted to examine the potential of the Interactive Walkway for the assessment of fall risk and informing on tailored falls prevention programs in people with PD and in other populations with impaired walking ability.
在帕金森病（PD）患者中，随着病情进展，步行能力的多个方面会逐渐恶化。临床测试通常评估步行的单个方面，在较小程度上评估涉及步行能力三个关键方面（即产生步幅、维持姿势平衡、适应步行）组合的更复杂步行任务。交互式步道能够评估更复杂的步行任务，以解决与患者日常生活步行相关的特征，包括适应性步行和双任务步行。为了评估交互式步道评估在PD患者中的预期附加值，我们首先评估了其在无约束步行、适应性步行和双任务步行结果测量方面的已知组效度。随后，将这些结果测量与常用的临床测试分数相关联。最后，我们评估了这些结果相对于临床测试分数在区分有无步态冻结的PD患者方面的预期附加值。交互式步道结果测量在预期方向上显示出冻结者、非冻结者和健康对照之间的显著差异。大多数交互式步道结果测量与临床测试分数无相关性或至多呈中度相关。最后，适应性步行的交互式步道结果测量在区分冻结者和非冻结者方面比临床测试分数略好。我们证实了交互式步道评估的附加值，它提供了对步行能力的全面评估，纳入了其三个关键方面的特征。未来的研究有必要探讨交互式步道在评估PD患者及其他步行能力受损人群跌倒风险和为量身定制的跌倒预防计划提供信息方面的潜力。
