Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Genoa, Italy.
Department of Experimental Medicine (DIMES), Section of Human Physiology, University of Genoa, Genoa, Italy.
Neurosci Biobehav Rev. 2023 Jul;150:105189. doi: 10.1016/j.neubiorev.2023.105189. Epub 2023 Apr 20.
The difficulty in assessing FOG and the variety of existing cues, hamper to determine which cueing modality should be applied and which FOG-related aspect should be targeted to reach personalized treatments for FOG. This systematic review aimed to highlight: i) whether cues could reduce FOG and improve FOG-related gait parameters, ii) which cues are the most effective, iii) whether medication state (ON-OFF) affects cues-related results. Thirty-three repeated measure design studies assessing cueing effectiveness were included and subdivided according to gait tasks (gait initiation, walking, turning) and to the medication state. Main results reveal that: preparatory phase of gait initiation benefit from visual and auditory cues; spatio-temporal parameters (e.g., step and stride length) are improved by visual cues during walking; turning time and step time variability are reduced by applying auditory and visual cues. Some findings on the potential benefits of cueing on FOG and FOG gait-related parameters were found. Questions remain about which are the best behavioral strategies according to FOG features and PD clinical characteristics.
评估冻结步态(FOG)的难度以及现有的各种提示方式,阻碍了我们确定应该应用哪种提示方式以及针对哪些与 FOG 相关的方面,以实现针对 FOG 的个性化治疗。本系统评价旨在强调:i)提示是否可以减少 FOG 并改善与 FOG 相关的步态参数,ii)哪种提示最有效,iii)药物状态(开/关)是否会影响与提示相关的结果。共纳入了 33 项重复测量设计研究,评估了提示的有效性,并根据步态任务(步态启动、行走、转弯)和药物状态进行了细分。主要结果表明:在步态启动的准备阶段,视觉和听觉提示有助于改善;在行走过程中,视觉提示可以改善时空参数(如步幅和步长);应用听觉和视觉提示可以减少转弯时间和步长变化的可变性。关于提示对 FOG 和 FOG 步态相关参数的潜在益处,已经有了一些发现。但仍存在一些问题,即根据 FOG 的特征和 PD 临床特征,哪种行为策略是最佳策略。
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