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焦虑对帕金森病步态障碍的影响:基于传感器的步态分析的见解。

The impact of anxiety on gait impairments in Parkinson's disease: insights from sensor-based gait analysis.

机构信息

Department of Neurology, Ningbo NO.2 Hospital, Ningbo, Zhejiang Province, China.

Department of Emergency Medicine, University of Hong Kong, Hong Kong SAR, China.

出版信息

J Neuroeng Rehabil. 2024 Apr 30;21(1):68. doi: 10.1186/s12984-024-01364-3.

Abstract

BACKGROUND

Sensor-based gait analysis provides a robust quantitative tool for assessing gait impairments and their associated factors in Parkinson's disease (PD). Anxiety is observed to interfere with gait clinically, but this has been poorly investigated. Our purpose is to utilize gait analysis to uncover the effect of anxiety on gait in patients with PD.

METHODS

We enrolled 38 and 106 PD patients with and without anxiety, respectively. Gait parameters were quantitively examined and compared between two groups both in single-task (ST) and dual-task (DT) walking tests. Multiple linear regression was applied to evaluate whether anxiety independently contributed to gait impairments.

RESULTS

During ST, PD patients with anxiety presented significantly shorter stride length, lower gait velocity, longer stride time and stance time, longer stance phase, smaller toe-off (TO) and heel-strike (HS) angles than those without anxiety. While under DT status, the differences were diminished. Multiple linear regression analysis demonstrated that anxiety was an independent factor to a serials of gait parameters, particularly ST-TO (B = -2.599, (-4.82, -0.38)), ST-HS (B = -2.532, (-4.71, -0.35)), ST-TO-CV (B = 4.627, (1.71, 7.64)), ST-HS-CV(B = 4.597, (1.66, 7.53)), ST stance phase (B = 1.4, (0.22, 2.58)), and DT stance phase (B = 1.749, (0.56, 2.94)).

CONCLUSION

Our study discovered that anxiety has a significant impact on gait impairments in PD patients, especially exacerbating shuffling steps and prolonging stance phase. These findings highlight the importance of addressing anxiety in PD precision therapy to achieve better treatment outcomes.

摘要

背景

基于传感器的步态分析为评估帕金森病(PD)患者的步态障碍及其相关因素提供了一种强大的定量工具。临床上观察到焦虑会干扰步态,但对此研究甚少。我们的目的是利用步态分析揭示焦虑对 PD 患者步态的影响。

方法

我们分别招募了 38 名和 106 名有和无焦虑的 PD 患者。在单任务(ST)和双重任务(DT)步行测试中,对两组患者的步态参数进行了定量检查和比较。应用多元线性回归评估焦虑是否独立导致步态障碍。

结果

在 ST 中,有焦虑的 PD 患者的步长、步态速度、步长时间和站立时间明显更短,站立相更长,TO 和 HS 角度更小。而在 DT 状态下,差异减小。多元线性回归分析表明,焦虑是一系列步态参数的独立因素,特别是 ST-TO(B = -2.599,(-4.82,-0.38))、ST-HS(B = -2.532,(-4.71,-0.35))、ST-TO-CV(B = 4.627,(1.71,7.64))、ST-HS-CV(B = 4.597,(1.66,7.53))、ST 站立相(B = 1.4,(0.22,2.58))和 DT 站立相(B = 1.749,(0.56,2.94))。

结论

我们的研究发现,焦虑对 PD 患者的步态障碍有显著影响,尤其是加重了拖步和延长了站立相。这些发现强调了在 PD 精准治疗中解决焦虑问题的重要性,以实现更好的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40af/11059709/634a224e2cf9/12984_2024_1364_Fig1_HTML.jpg

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