Exercise Research Laboratory, Universidade Federal Do Rio Grande Do Sul, 750 Felizardo St, Porto Alegre, RS, 90690-200, Brazil.
Univel University Center, Cascavel, Brazil.
Sci Rep. 2021 Jan 12;11(1):752. doi: 10.1038/s41598-020-80768-2.
We systematically reviewed observational and clinical trials (baseline) studies examining differences in gait parameters between Parkinson's disease (PD) in on-medication state and healthy control. Four electronic databases were searched (November-2018 and updated in October-2020). Independent researchers identified studies that evaluated gait parameters measured quantitatively during self-selected walking speed. Risk of bias was assessed using an instrument proposed by Downs and Black (1998). Pooled effects were reported as standardized mean differences and 95% confidence intervals using a random-effects model. A total of 72 studies involving 3027 participants (1510 with PD and 1517 health control) met the inclusion criteria. The self-selected walking speed, stride length, swing time and hip excursion were reduced in people with PD compared with healthy control. Additionally, PD subjects presented higher cadence and double support time. Although with a smaller difference for treadmill, walking speed is reduced both on treadmill (.13 m s) and on overground (.17 m s) in PD. The self-select walking speed, stride length, cadence, double support, swing time and sagittal hip angle were altered in people with PD compared with healthy control. The precise determination of these modifications will be beneficial in determining which intervention elements are most critical in bringing about positive, clinically meaningful changes in individuals with PD (PROSPERO protocol CRD42018113042).
我们系统地回顾了观察性和临床试验(基线)研究,这些研究检查了处于用药状态的帕金森病(PD)与健康对照组之间步态参数的差异。我们检索了四个电子数据库(2018 年 11 月,并于 2020 年 10 月更新)。独立研究人员确定了评估在自我选择的步行速度下定量测量的步态参数的研究。使用 Downs 和 Black(1998)提出的工具评估偏倚风险。使用随机效应模型报告汇总效应作为标准化均数差和 95%置信区间。共有 72 项研究涉及 3027 名参与者(1510 名 PD 和 1517 名健康对照)符合纳入标准。与健康对照组相比,PD 患者的自我选择步行速度、步长、摆动时间和髋关节伸展幅度减小。此外,PD 患者的步频和双支撑时间更高。尽管在跑步机上的差异较小,但 PD 患者在跑步机(0.13 m/s)和地面(0.17 m/s)上的步行速度均降低。与健康对照组相比,PD 患者的自我选择步行速度、步长、步频、双支撑、摆动时间和矢状面髋关节角度发生改变。这些改变的精确确定将有助于确定哪些干预要素对 PD 个体产生积极的、具有临床意义的改变最为关键(PROSPERO 方案 CRD42018113042)。