Preston E, Salmon R, de Meillon N, Boom M, Ada L, Mahendran N, Flynn A
University of Canberra, Guraguma St, Bruce, ACT 2617, Australia.
University of Canberra, Guraguma St, Bruce, ACT 2617, Australia.
Gait Posture. 2023 Feb;100:103-106. doi: 10.1016/j.gaitpost.2022.11.061. Epub 2022 Dec 1.
Bradykinesia and postural instability contribute to walking limitations in people with Parkinson's disease (PD), but the contribution of muscle strength to walking speed has not been examined extensively.
Does strength of the major lower limb muscles contribute to walking speed over short and long distances in people with PD?
na.
A cross-sectional, observational study.
50 people with mild PD.
Maximum isometric strength of the flexors and extensors of the lower limb was measured using hand-held dynamometry. Flexed posture, postural instability and bradykinesia were measured using the MDS-UPDRS part III. Walking speed was measured during the 10-m Walk Test and 6-min Walk Test.
Univariate analysis revealed that age, bradykinesia, flexed posture, and hip, knee and ankle weakness were all significantly correlated with walking speed over short and long distances. Multiple regression analysis revealed that age, bradykinesia, flexed posture and weakness of the hip and knee muscles together accounted for 47% of the variance in walking speed over a short distance, with age (R = 0.11, p = 0.003) making a significant independent contribution. Age, bradykinesia, flexed posture and strength of the hip and knee muscles together accounted for 56% of the variance in walking speed over a long distance. Age (R = 0.12, p = 0.001), weakness of the hip muscles (R = 0.12, p = 0.001) and bradykinesia (R = 0.04, p = 0.04) made significant, independent contributions to the variance in walking speed over a long distance.
In people with mild PD, weakness of the hip muscles and bradykinesia only make a significant relative contribution to walking speed over a long distance. Therefore, in people with normal walking speed over a short distance the 6-min Walk Test could be measured to more effectively identify the impact of motor impairments on walking.
运动迟缓及姿势不稳导致帕金森病（PD）患者行走受限，但肌肉力量对步行速度的影响尚未得到广泛研究。
PD患者下肢主要肌肉力量对其短距离和长距离步行速度是否有影响？
无。
一项横断面观察性研究。
50例轻度PD患者。
采用手持测力计测量下肢屈肌和伸肌的最大等长肌力。采用MDS-UPDRS第三部分评估屈曲姿势、姿势不稳和运动迟缓。在10米步行试验和6分钟步行试验中测量步行速度。
单因素分析显示，年龄、运动迟缓、屈曲姿势以及髋部、膝部和踝部肌力减弱均与短距离和长距离步行速度显著相关。多元回归分析显示，年龄、运动迟缓、屈曲姿势以及髋部和膝部肌肉无力共同解释了短距离步行速度变异的47%，其中年龄（R = 0.11，p = 0.003）有显著独立贡献。年龄、运动迟缓、屈曲姿势以及髋部和膝部肌肉力量共同解释了长距离步行速度变异的56%。年龄（R = 0.12，p = 0.001）、髋部肌肉无力（R = 0.12，p = 0.001）和运动迟缓（R = 0.04，p = 0.04）对长距离步行速度变异有显著独立贡献。
在轻度PD患者中，髋部肌肉无力和运动迟缓仅对长距离步行速度有显著相对影响。因此，对于短距离步行速度正常的患者，可进行6分钟步行试验，以更有效地识别运动障碍对步行的影响。
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