Ganapathy V S, James Tittu T, Philip Mariamma, Kamble Nitish, Bhattacharya Amitabh, Dhargave Pradnya, Pal Pramod Kumar
National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Ann Indian Acad Neurol. 2021 Jul-Aug;24(4):518-523. doi: 10.4103/aian.AIAN_1090_20. Epub 2021 May 21.
Establishing an association between gait variability and direction specific balance indices may help in identifying the risk of falls in patients with spinocerebellar ataxia (SCA) which may help in developing an appropriate intervention. This study is intended to identify the association between balance and gait parameters especially gait variability in these patients.
Patients with genetically confirmed SCA ( = 24) as well as controls ( = 24) who met the study criteria were recruited. Gait was assessed using the GAITRite system and balance was assessed using dynamic posturography (Biodex) to record direction-specific dynamic balance indices. Disease severity was assessed using international cooperative ataxia rating scale (ICARS).
The mean age of the SCA group (38.83 ± 13.03 years) and the control group (36.38 ± 9.09 years) were comparable. The age of onset of illness was 32 ± 10.62 years and duration of 5.67 ± 3.62 years. The mean ICARS was 45.10 ± 16.75. There was a significant difference in the overall balance index (OBI), anterior-posterior index (API), medial/lateral index (MLI) between SCA patients (4.56 ± 2.09, 3.49 ± 1.88, 2.94 ± 1.32) and the controls (2.72 ± 1.25, 2.08 ± 0.85, 1.85 ± 0.97). However, correlation was observed only between gait stability and balance parameters in API direction.
There was an increased anteroposterior oriented balance deficit in patients with SCA, which was significantly correlating with the gait parameters. The balance training intervention may focus on improving anteroposterior direction to prevent falls and improving walking efficiency.
确定步态变异性与特定方向平衡指标之间的关联，可能有助于识别脊髓小脑共济失调（SCA）患者的跌倒风险，这可能有助于制定适当的干预措施。本研究旨在确定这些患者的平衡与步态参数之间的关联，尤其是步态变异性。
招募了符合研究标准的经基因确诊的SCA患者（n = 24）以及对照组（n = 24）。使用GAITRite系统评估步态，并使用动态姿势描记法（Biodex）评估平衡，以记录特定方向的动态平衡指标。使用国际合作共济失调评定量表（ICARS）评估疾病严重程度。
SCA组（38.83±13.03岁）和对照组（36.38±9.09岁）的平均年龄具有可比性。发病年龄为32±10.62岁，病程为5.67±3.62年。平均ICARS为45.10±16.75。SCA患者（4.56±2.09、3.49±1.88、2.94±1.32）与对照组（2.72±1.25、2.08±0.85、1.85±0.97）之间的总体平衡指数（OBI）、前后指数（API）、内侧/外侧指数（MLI）存在显著差异。然而，仅在API方向的步态稳定性与平衡参数之间观察到相关性。
SCA患者存在前后方向平衡缺陷增加，这与步态参数显著相关。平衡训练干预可侧重于改善前后方向以预防跌倒并提高步行效率。
