Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA.
J Intellect Disabil Res. 2020 Oct;64(10):793-803. doi: 10.1111/jir.12773. Epub 2020 Sep 4.
Adults with intellectual disabilities (ID) often have polypharmacy and often use antipsychotics. Both polypharmacy and antipsychotics have a negative effect on gait in the general population, but this has not been studied in adults with ID. These negative effects may add to pre-existing gait disturbances in adults with ID and increase the risk for adverse health outcomes in this population. Therefore, the aim of this study is to investigate the difference in gait parameters between adults with ID with and without polypharmacy and between adults with ID using and not using antipsychotics.
The gait parameters of 31 participants were collected with the GAITRite walkway, a pressure sensitive walkway measuring spatial and temporal gait parameters, in addition to information about personal characteristics, prescribed medication and presence of polypharmacy.
After adjustment for sex and body mass index, participants with polypharmacy had a significantly shorter step length [polypharmacy B (SE) = -0.079 (0.034), P = 0.03], shorter stride length [polypharmacy B (SE) = -0.157 (0.069), P = 0.03] and longer double support time [polypharmacy B (SE) = 0.0004 (0.0001), P = 0.047]. Participants using antipsychotics had a significantly longer double support time [antipsychotic use B (SE) = 0.0003 (0.0002), P = 0.019].
This study showed for the first time that both polypharmacy and using antipsychotics are associated with gait in adults with ID. The differences seem to resemble a more cautious gait. Further investigation with larger study samples, additional medication types and dosages are needed to acquire more insight in this important topic.
智障成年人(ID)通常同时服用多种药物,并且经常使用抗精神病药物。在普通人群中,药物的联合使用和抗精神病药物的使用均对步态产生负面影响,但在 ID 成年人中尚未对此进行研究。这些负面影响可能会加重 ID 成年人已存在的步态障碍,并增加该人群发生不良健康后果的风险。因此,本研究旨在探讨 ID 成年人中药物联合使用和抗精神病药物使用与未使用对步态参数的差异。
使用步态分析系统(GAITRite 步道)测量了 31 名参与者的步态参数,该系统是一种压力敏感步道,可测量空间和时间步态参数,以及个人特征、处方药物和多药使用的信息。
在调整性别和体重指数后,多药使用者的步长显著缩短[多药使用 B(SE)=-0.079(0.034),P=0.03],步幅显著缩短[多药使用 B(SE)=-0.157(0.069),P=0.03],双支撑时间显著延长[多药使用 B(SE)=0.0004(0.0001),P=0.047]。使用抗精神病药物的参与者的双支撑时间显著延长[抗精神病药物使用 B(SE)=0.0003(0.0002),P=0.019]。
本研究首次表明,多药使用和使用抗精神病药物均与 ID 成年人的步态相关。这些差异似乎类似于更谨慎的步态。需要进一步进行更大样本量、附加药物类型和剂量的研究,以更深入地了解这一重要问题。