Department of Physical Therapy, Eulji University, Republic of Korea.
Department of Optometry, Eulji University, Republic of Korea.
Medicine (Baltimore). 2021 Aug 13;100(32):e26938. doi: 10.1097/MD.0000000000026938.
Glaucoma, is the most common cause of irreversible visual deficits, presents as an injury to the optic nerve and it is mainly associated with elevated intraocular pressure. The main symptom of glaucoma is a reduction of the visual field, which is usually a source of complaint at the advanced stage of disease. Because of visual deficit, gait dysfunctions, including low gait speed and increased bumping into objects, postural sway, and falling are occurred. Many studies have used stopwatch or motion-sensing devices to report on gait function following glaucoma. However, there are few reports on gait dysfunction assessed by examining foot pressure. This study investigated gait ability following glaucoma according to different gait conditions by assessing foot pressure.
Thirty older adults (15 in the sex- and age-matched normal group and 15 in the glaucoma group) were recruited for this study. All participants were walked under 2 different gait conditions in an F-scan system and the subject' assessments were randomly assigned to rule out the order effect. Conditions included: gait over an obstacle in a straight 6 m path, gait in a straight path without an obstacle in the 6 m path. Gait variables included cadence, gait cycle, stance time, center of force (COF) deviation, and COF excursion. About 10 minutes were taken for gait evaluation.
When walking without an obstacle on a 6 m path, there were significant differences between the 2 groups in gait speed, cadence, gait cycle, and stance time (P < .05). There were significant differences when walking with an obstacle on a 6 m path (P < .05). Two-way analysis of variance showed significant effects associated with "glaucoma" not gait condition on all outcomes except for COF deviation and excursion. Also, there was no the interaction effect between "glaucoma" and "gait condition."
We demonstrated that glaucoma patients selected the gait strategy such as lower gait function in both gait conditions particularly, slower gait speed and cadence and longer gait cycle and stance time, as determined by examining foot pressure. We believe that our results could help to improve the quality of life of patients with glaucoma.
青光眼是最常见的不可逆视力损伤原因，表现为视神经损伤，主要与眼内压升高有关。青光眼的主要症状是视野缩小，通常在疾病晚期才出现抱怨。由于视力缺陷，步态功能受损，包括步速降低和增加撞到物体、姿势摆动和跌倒。许多研究使用秒表或运动感应设备来报告青光眼后的步态功能。然而，很少有关于通过检查足底压力评估步态功能障碍的报道。本研究通过检查足底压力，根据不同的步态条件评估青光眼后的步态能力。
本研究共纳入 30 名老年人（15 名年龄和性别匹配的正常组和 15 名青光眼组）。所有参与者均在 F-scan 系统下以两种不同的步态条件行走，并且受试者的评估是随机分配的，以排除顺序效应。条件包括：在 6m 直线路径上越过障碍物行走，在 6m 直线路径上无障碍行走。步态变量包括步频、步态周期、支撑时间、力中心（COF）偏差和 COF 偏移。步态评估大约需要 10 分钟。
在无障碍行走 6m 路径时，两组之间的步态速度、步频、步态周期和支撑时间存在显著差异（P <.05）。在 6m 路径上有障碍物行走时存在显著差异（P <.05）。双因素方差分析显示，除了 COF 偏差和偏移外，与“青光眼”无关的步态条件对所有结果都有显著影响。此外，“青光眼”和“步态条件”之间没有交互作用。
我们通过足底压力检查发现，青光眼患者在两种步态条件下（尤其是在无障碍行走 6m 路径和有障碍物行走 6m 路径时）选择了较低的步态功能策略，表现为较慢的步速和步频、较长的步态周期和支撑时间。我们相信，我们的结果可以帮助提高青光眼患者的生活质量。
