Young David R, Suter Bernhard, Levine Jackson T, Glaze Daniel G, Layne Charles S
Department of Health and Human Performance, University of Houston, Houston, TX, USA.
Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX, USA.
Disabil Rehabil. 2022 Apr;44(8):1508-1515. doi: 10.1080/09638288.2020.1820084. Epub 2020 Sep 15.
Individuals with Rett syndrome (RTT) exhibit impaired motor performance and gait performance, leading to decreased quality of life. Currently, there is no robust observational instrument to identify gait characteristics in RTT. Current scales are limited as individuals with intellectual disorders may be unable to understand instructions. Our primary purpose was to utilize video analysis to characterize the behaviors associated with walking in individuals with RTT and explore the relationship between behaviors during overground and during treadmill walking.
Fourteen independently ambulatory females with RTT were video-taped and observed during overground and treadmill walking. Their gait was codified into an observational checklist to reveal prominent features associated with gait in this population.
Participants exhibited similar rates of freezing, veering, and hand stereotypies between overground and treadmill walking; however, freeze duration was shortened during treadmill walking. Toe walking was prominently exhibited during overground, but not treadmill walking. During both walking modes, participants required extensive external motivation to maintain their walking patterns.
Results identify several gait characteristics observable during overground and treadmill walking. In general, participants behaved similarly during overground and treadmill walking. We conclude that both overground and treadmill walking are appropriate tools to evaluate gait in this population.Implications for rehabilitationLocomotor rehabilitation may increase the quantity of walking performed by the patients, which can alleviate negative effects of the sedentary lifestyle commonly observed in patients with Rett syndrome (RTT).Video analysis of natural walking can be an effective tool to characterize gait in patients with RTT which does not require particular instructions which may not be fully understood.Both overground and treadmill walking are appropriate means of evaluating gait in individuals with RTT.
雷特综合征（RTT）患者存在运动能力和步态表现受损的情况，导致生活质量下降。目前，尚无强大的观察工具来识别RTT患者的步态特征。现有的量表存在局限性，因为智力障碍患者可能无法理解指令。我们的主要目的是利用视频分析来描述RTT患者行走相关的行为，并探讨地面行走和跑步机行走时行为之间的关系。
对14名能够独立行走的RTT女性患者在地面行走和跑步机行走时进行录像观察。她们的步态被编入观察检查表，以揭示该人群中与步态相关的突出特征。
参与者在地面行走和跑步机行走时出现冻结、转向和手部刻板动作的发生率相似；然而，跑步机行走时冻结持续时间缩短。地面行走时明显表现出足尖行走，而跑步机行走时则没有。在两种行走模式下，参与者都需要大量外部激励来维持行走模式。
结果确定了在地面行走和跑步机行走时可观察到的几种步态特征。总体而言，参与者在地面行走和跑步机行走时表现相似。我们得出结论，地面行走和跑步机行走都是评估该人群步态的合适工具。
对康复的启示
运动康复可能会增加患者的行走量，这可以减轻雷特综合征（RTT）患者中常见的久坐生活方式的负面影响。
对自然行走进行视频分析可以成为一种有效的工具，用于描述RTT患者的步态，该方法不需要可能无法被完全理解的特定指令。
地面行走和跑步机行走都是评估RTT患者步态的合适方式。
