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帕金森病步态运动学参数:系统评价。

Gait Kinematic Parameters in Parkinson's Disease: A Systematic Review.

机构信息

Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal.

CNS - Campus Neurológico Sénior, Torres Vedras, Portugal.

出版信息

J Parkinsons Dis. 2020;10(3):843-853. doi: 10.3233/JPD-201969.

Abstract

BACKGROUND

Gait impairments are common and highly disabling for Parkinson's disease (PD) patients. With the development of technology-based tools, it is now possible to measure the spatiotemporal parameters of gait with a reduced margin of error, thereby enabling a more accurate characterization of impairment.

OBJECTIVE

To summarize and critically appraise the characteristics of technology-based gait analysis in PD and to provide mean and standard deviation values for spatiotemporal gait parameters.

METHODS

A systematic review was conducted using the databases CENTRAL, MEDLINE, Embase, and PEDro from their inception to September 2019 to identify all observational and experimental studies conducted in PD or atypical parkinsonism that included a technology-based gait assessment. Two reviewers independently screened citations and extracted data.

RESULTS

We included 95 studies, 82.1% (n = 78) reporting a laboratory gait assessment and 61.1% (n = 58 studies) using a wearable sensor. The most frequently reported parameters were gait velocity, stride and step length, and cadence. A statistically significant difference was found when comparing the mean values of each of these parameters in PD patients versus healthy controls. No statistically significant differences were found in the mean value of the parameters when comparing wearable versus non-wearable sensors, different types of wearable sensors, and different sensor locations.

CONCLUSION

Our results provide useful information for performing objective technology-based gait assessment in PD, as well as mean values to better interpret the results. Further studies should explore the clinical meaningfulness of each parameter and how they behave in a free-living context and throughout disease progression.

摘要

背景

步态障碍在帕金森病(PD)患者中较为常见且严重致残。随着基于技术工具的发展,现在可以用更小的误差来测量步态的时空参数,从而更准确地描述障碍。

目的

总结和批判性评价基于技术的 PD 步态分析的特点,并提供时空步态参数的平均值和标准差值。

方法

使用 CENTRAL、MEDLINE、Embase 和 PEDro 数据库,从成立到 2019 年 9 月,进行系统评价,以确定所有在 PD 或非典型帕金森病中进行的基于技术的步态评估的观察性和实验性研究。两名评审员独立筛选引用文献并提取数据。

结果

我们纳入了 95 项研究,82.1%(n=78)报告了实验室步态评估,61.1%(n=58 项)使用了可穿戴传感器。报道最多的参数是步态速度、步幅和步长以及步频。在 PD 患者与健康对照者之间比较这些参数的平均值时,发现有统计学上的显著差异。在比较可穿戴与非可穿戴传感器、不同类型的可穿戴传感器以及不同的传感器位置时,未发现参数平均值有统计学上的显著差异。

结论

我们的结果为在 PD 中进行客观的基于技术的步态评估提供了有用的信息,同时还提供了平均值,以便更好地解释结果。进一步的研究应探讨每个参数的临床意义,以及它们在自由生活环境中和疾病进展过程中的表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0080/7458503/d9c296d9adbe/jpd-10-jpd201969-g001.jpg

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