Tosserams Anouk, Wit Lisanne, Sturkenboom Ingrid H W M, Nijkrake Maarten J, Bloem Bastiaan R, Nonnekes Jorik
From the Department of Neurology (A.T., B.R.B.) and Department of Rehabilitation (A.T., L.W., I.H.W.M.S., M.J.N., J.N.), Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre; and Department of Rehabilitation (J.N.), Sint Maartenskliniek, Nijmegen, the Netherlands.
Neurology. 2021 Oct 4;97(14):e1404-e1412. doi: 10.1212/WNL.0000000000012633.
Gait impairments are common and disabling in Parkinson disease (PD). Applying compensation strategies helps to overcome these gait deficits. Clinical observations suggest that the efficacy of different compensation strategies varies depending on both individual patient characteristics and the context in which the strategies are applied. This has never been investigated systematically, hampering the ability of clinicians to provide a more personalized approach to gait rehabilitation. We had 3 aims: (1) to evaluate patients' awareness and actual use of compensation categories for gait impairments in PD, (2) to investigate the patient-rated efficacy of the various compensation strategies and whether this efficacy depends on the context in which the strategies are applied, and (3) to explore differences in the efficacy between subgroups based on sex, age, disease duration, freezing status, and ability to perform a dual task.
A survey was conducted among 4,324 adults with PD and self-reported disabling gait impairments.
The main findings are as follows: (1) compensation strategies for gait impairments are commonly used by persons with PD, but their awareness of the full spectrum of available strategies is limited; (2) the patient-rated efficacy of compensation strategies is high but varies depending on the context in which they are applied; and (3) compensation strategies are useful for all types of patients with PD, but the efficacy of the different strategies varies per person.
The choice of compensation strategies for gait impairment in PD should be tailored to the individual patient and to the context in which the strategy needs to be applied.
This data provides Class IV evidence that compensation strategies are an effective treatment for gait impairment in patients with PD.
步态障碍在帕金森病（PD）中很常见且会导致残疾。应用补偿策略有助于克服这些步态缺陷。临床观察表明，不同补偿策略的效果因个体患者特征以及应用策略的背景而异。这从未得到系统研究，阻碍了临床医生提供更个性化的步态康复方法。我们有三个目标：（1）评估PD患者对步态障碍补偿类别的认知及实际使用情况；（2）调查各种补偿策略在患者自评中的效果以及该效果是否取决于策略的应用背景；（3）探讨基于性别、年龄、病程、冻结状态和执行双重任务能力的亚组之间在效果上的差异。
对4324名有PD且自我报告存在致残性步态障碍的成年人进行了一项调查。
主要发现如下：（1）PD患者普遍使用步态障碍补偿策略，但他们对所有可用策略的认知有限；（2）补偿策略在患者自评中的效果较高，但因应用背景而异；（3）补偿策略对所有类型的PD患者都有用，但不同策略的效果因人而异。
PD步态障碍补偿策略的选择应根据个体患者以及策略应用的背景进行调整。
该数据提供了IV类证据，表明补偿策略是治疗PD患者步态障碍的有效方法。
Zotero 插件