帕金森病患者的行走困难感知 - 预测因素及其随时间的变化。
Perceived walking difficulties in Parkinson's disease - predictors and changes over time.
机构信息
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Memory Clinic, Skåne University Hospital, Malmö, Sweden.
出版信息
BMC Geriatr. 2021 Apr 1;21(1):221. doi: 10.1186/s12877-021-02113-0.
BACKGROUND
People with Parkinson's disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties.
METHODS
One hundred forty-eight people with PD (mean age 67.9 years) completed the Generic Walk-12 (Walk-12G) questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties.
RESULTS
Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.8 versus 18.7, p < 0.001. Concerns about falling was the strongest predictor (β = 0.445) of perceived walking difficulties, followed by perceived balance problems while dual tasking (β = 0.268) and pain (β = 0.153). Perceived balance problems while dual tasking was the strongest predictor (β = 0.180) of a change in perceived walking difficulties, followed by global cognitive functioning (β = - 0.107).
CONCLUSIONS
Perceived walking difficulties increase over time in people with PD. Both personal factors (i.e. concerns about falling) and motor aspects (i.e. balance problems while dual tasking) seem to have a predictive role. Importantly, our study indicates that also non-motor symptoms (e.g. pain and cognitive functioning) seem to be of importance for future perceived walking difficulties. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.
背景
帕金森病（PD）患者将其行走困难描述为与活动回避、社会孤立、独立性降低和生活质量下降有关。对于 PD 患者感知行走困难的预测因素，目前还存在知识空白。当设计干预研究时，这些知识可能会很有用。本研究旨在调查 PD 患者在 3 年内感知行走困难的演变情况。一个具体目标是确定感知行走困难的预测因素。
方法
148 名 PD 患者（平均年龄 67.9 岁）在基线和 3 年随访时均完成了通用步行 12 项（Walk-12G）问卷（评估感知行走困难）。采用配对样本 t 检验比较基线和随访时的平均评分。采用多元线性回归分析确定感知行走困难的预测因素。
结果
感知行走困难在 3 年后增加：平均 Walk-12G 评分从 14.8 增加到 18.7，p<0.001。对跌倒的担忧是感知行走困难的最强预测因素（β=0.445），其次是双重任务时的感知平衡问题（β=0.268）和疼痛（β=0.153）。双重任务时的感知平衡问题是感知行走困难变化的最强预测因素（β=0.180），其次是整体认知功能（β=-0.107）。
结论
PD 患者的感知行走困难随时间推移而增加。个人因素（如对跌倒的担忧）和运动方面（如双重任务时的平衡问题）似乎都具有预测作用。重要的是，我们的研究表明，非运动症状（如疼痛和认知功能）对未来的感知行走困难也很重要。未来需要解决这些因素的干预研究需要证实它们对感知行走困难的预防作用。
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