神经障碍患者改良动态步态指数的仪器化版本。

Instrumented Version of the Modified Dynamic Gait Index in Patients With Neurologic Disorders.

机构信息

LaRiCE: Gait and Balance Disorders Laboratory, Department of Neurorehabilitation, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.

Biomedical Technology Department, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.

出版信息

PM R. 2019 Dec;11(12):1312-1319. doi: 10.1002/pmrj.12137. Epub 2019 Jun 17.

DOI:10.1002/pmrj.12137

PMID:30737890

Abstract

BACKGROUND

Gait instability is common in adults with neurologic disorders and the modified Dynamic Gait Index (mDGI) was recently introduced to assess dynamic balance. However, instrumental assessment is needed to provide quantitative measures.

OBJECTIVE

To develop and validate an instrumented version of the mDGI.

DESIGN

Cross-sectional study.

SETTING

Clinical setting.

PARTICIPANTS

Thirty adults with neurologic disorders (10 with multiple sclerosis, 10 with Parkinson disease, and 10 with stroke) and 20 healthy volunteers.

METHODS

Participants were assessed with the Timed Up and Go test (TUG) and with the mDGI. During the assessment of mDGI, data were collected by a single Inertial Measurement Unit (IMU) positioned on the sternum. Principal component analysis (PCA) was performed on the instrumented data extracting eight PC scores (ImPC) describing dynamic balance. The instrumented overall score (ImDGI) was then calculated as the sum of the mPCs. PCA revealed two components associated with stride features and regularity (ImDGI_Gait_Pattern) and trunk movements (ImDGI_Trunk_Sway). Spearman coefficients were calculated between mDGI and ImDGI, whereas Mann-Whitney (U) and Kruskal-Wallis (H) tests assessed differences between groups and neurologic conditions.

MAIN OUTCOME MEASUREMENTS

ImDGI.

RESULTS

ImDGI did not show ceiling effects, and good correlations were found between ImDGI and mDGI (r = .84), and TUG (r = .84) for people with neurologic disorders (P < .001). Significant differences among pathologies (H test =12.5, P = .002) and between healthy participants and adults with neurologic disorders (U test = 47.0, P = .001) were found. ImDGI_Trunk_Sway discriminated between people using or not using walking aids and among the three pathologies (H = 10.0, P = .007).

CONCLUSIONS

The ImDGI test seems to provide valid measures to objectively assess dynamic balance in neurologic conditions and possibly quantify balance deficits also in adults with neurologic disorders.

摘要

背景

步态不稳定在患有神经障碍的成年人中很常见，最近引入了改良动态步态指数（mDGI）来评估动态平衡。然而，需要仪器评估来提供定量测量。

目的

开发和验证 mDGI 的仪器版本。

设计

横断面研究。

设置

临床环境。

参与者

30 名患有神经障碍的成年人（10 名多发性硬化症、10 名帕金森病和 10 名中风）和 20 名健康志愿者。

方法

参与者接受计时起立行走测试（TUG）和 mDGI 评估。在 mDGI 评估期间，通过放置在胸骨上的单个惯性测量单元（IMU）收集数据。对仪器数据进行主成分分析（PCA），提取描述动态平衡的八个 PC 分数（ImPC）。然后，将仪器总得分（ImDGI）计算为 mPC 的总和。PCA 揭示了与步幅特征和规律性（ImDGI_Gait_Pattern）以及躯干运动（ImDGI_Trunk_Sway）相关的两个分量。计算了 mDGI 与 ImDGI 之间的斯皮尔曼系数，而 Mann-Whitney（U）和 Kruskal-Wallis（H）检验评估了组间和神经状况的差异。

主要测量结果

ImDGI。

结果

ImDGI 没有出现天花板效应，并且在患有神经障碍的人群中，ImDGI 与 mDGI（r=0.84）和 TUG（r=0.84）之间存在良好的相关性（P<0.001）。在不同的病理情况下（H 检验=12.5，P=0.002）和健康参与者与患有神经障碍的成年人之间（U 检验=47.0，P=0.001）发现了显著差异。ImDGI_Trunk_Sway 可区分使用或不使用助行器的人群以及三种病理情况（H=10.0，P=0.007）。