移动的帕金森病患者一定更活跃吗？
Are Mobile Persons With Parkinson Disease Necessarily More Active?
机构信息
Departments of Physical Therapy and Athletic Training (J.A.Z., T.B., T.R.D., T.N., T.D.E) and Occupational Therapy (D.F.), Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts; Department of Physical Therapy (J.T.C.), University of New England, Portland, Maine; Department of Kinesiology (C.C.-S.), College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, Connecticut; Program in Physical Therapy (R.P.D., K.S.R., G.M.E), Department of Neuroscience (G.M.E), and Department of Neurology (R.P.D., G.M.E), Washington University in St Louis School of Medicine, St Louis, Missouri; School of Public Health (M.L.), Boston University, Boston, Massachusetts; and Department of Neurology (M.S.-H., C.A.T.), Parkinson's Disease and Movement Disorders Center, Boston University, Boston, Massachusetts.
出版信息
J Neurol Phys Ther. 2021 Oct 1;45(4):259-265. doi: 10.1097/NPT.0000000000000362.
BACKGROUND AND PURPOSE
Walking activity in persons with Parkinson disease (PD) is important for preventing functional decline. The contribution of walking activity to home and community mobility in PD is poorly understood.
METHODS
Cross-sectional baseline data (N = 69) were analyzed from a randomized controlled PD trial. The Life-Space Assessment (LSA) quantified the extent, frequency, and independence across 5 expanding levels of home and community mobility, producing individual subscores and a total score. Two additional summed scores were used to represent mobility within (Levels 1-3) and beyond (Levels 4-5) neighborhood limits. An accelerometer measured walking activity for 7 days. Regression and correlation analyses evaluated relationships between daily steps and mobility scores. Mann-Whitney U tests secondarily compared differences in mobility scores between the active and sedentary groups.
RESULTS
Walking activity contributed significantly to the summed Level 1-3 score (β = 0.001, P = 0.004) but not to the summed Level 4-5 (β = 0.001, P = 0.33) or total (β = 0.002, P = 0.07) scores. Walking activity was significantly related to Level 1 (ρ = 0.336, P = 0.005), Level 2 (ρ = 0.307, P = 0.010), and Level 3 (ρ = 0.314, P = 0.009) subscores. Only the summed Level 1-3 score (P = 0.030) was significantly different between the active and sedentary groups.
DISCUSSION AND CONCLUSIONS
Persons with PD who demonstrated greater mobility beyond the neighborhood were not necessarily more active; walking activity contributed more so to home and neighborhood mobility. Compared with LSA total score, the Level 1-3 summed score may be a more useful participation-level measure for assessing the impact of changes in walking activity.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A349).
背景与目的
帕金森病（PD）患者的步行活动对预防功能下降很重要。步行活动对 PD 患者居家和社区移动能力的贡献尚不清楚。
方法
对一项随机对照 PD 试验的横断面基线数据（N=69）进行了分析。生活空间评估（LSA）量化了 5 个扩展水平的居家和社区移动范围的程度、频率和独立性，产生了个体子分数和总分数。另外两个加分数用于代表邻里限制内（水平 1-3）和超越（水平 4-5）的移动能力。加速度计连续 7 天测量步行活动。回归和相关分析评估了每日步数与移动能力评分之间的关系。曼-惠特尼 U 检验其次比较了活跃组和久坐组之间移动能力评分的差异。
结果
步行活动对总和 1-3 分（β=0.001，P=0.004）有显著贡献，但对总和 4-5 分（β=0.001，P=0.33）或总和（β=0.002，P=0.07）无显著贡献。步行活动与水平 1（ρ=0.336，P=0.005）、水平 2（ρ=0.307，P=0.010）和水平 3（ρ=0.314，P=0.009）子分数有显著关系。只有总和 1-3 分（P=0.030）在活跃组和久坐组之间有显著差异。
讨论与结论
表现出超越邻里范围更大移动能力的 PD 患者不一定更活跃；步行活动对居家和邻里移动能力的贡献更大。与 LSA 总分相比，总和 1-3 分可能是评估步行活动变化对参与度影响的更有用的指标。视频摘要可供作者提供更多见解（见视频，补充数字内容 1 可在以下网址获得：http://links.lww.com/JNPT/A349）。
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