Mei Jianing, Wang Yu, Zhu Dongyu, Li Yang, Gu Kan, Wei Zijun, Han Xueyi, Li Qianqian, Jiang Shuyun, Zhang Yunyun
Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Gait Analysis, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Clin Park Relat Disord. 2025 Feb 24;12:100309. doi: 10.1016/j.prdoa.2025.100309. eCollection 2025.
There is a scarcity of quantitative research on gait differences among patients with different motor subtypes of Parkinson's disease (PD), especially during the early and middle stages of the condition. The purpose of this study is to describe the gait characteristics of PD with different motor subtypes in the early and middle stages and to identify the most sensitive indicators of gait impairment.
General information, including age, gender, disease duration, levodopa equivalent daily dose (LEDD), and falls, was collected. Motor and non-motor symptoms of PD were assessed using multiple scales. Patients' walking function and lower limb joint movement ability were analyzed using a 3D gait analysis system.
The study included 64 patients with early and middle-stage PD, of whom 33 were classified as the TD subtype, 24 were classified as the PIGD subtype, and 7 were classified as the Mixed subtype. In addition, 5 healthy subjects were included in the evaluation as healthy controls. The PIGD patients have significantly higher LEDD (431.08 ± 250.90 mg vs. 302.08 ± 164.64 mg, p = 0.034) and a higher number of falls (0.29 vs. 0.00, p = 0.018) than the TD patients. The overall gait disturbances and motor and non-motor symptoms did not exhibit significant differences between TD and PIGD patients. However, the decrease in GDI (β = -0.730 vs. β = -0.235, p = 0.043) and hip flexion and extension range (β = -0.533 vs. β = -0.470, p < 0.001) was more pronounced in PIGD patients compared to TD patients as the MDS-UPDRS Ⅲ score increased.
There is no significant difference in gait severity between patients with TD and PIGD subtypes during the early and middle stages of PD. However, PIGD patients exhibit a more rapid progression of gait impairment than TD, particularly affecting hip mobility.
关于帕金森病（PD）不同运动亚型患者步态差异的定量研究较少，尤其是在疾病的早期和中期。本研究的目的是描述早期和中期不同运动亚型PD患者的步态特征，并确定步态障碍最敏感的指标。
收集患者的一般信息，包括年龄、性别、病程、左旋多巴等效日剂量（LEDD）和跌倒情况。使用多种量表评估PD的运动和非运动症状。采用三维步态分析系统分析患者的行走功能和下肢关节活动能力。
本研究纳入64例早中期PD患者，其中33例被分类为震颤为主型（TD）亚型，24例被分类为姿势不稳-步态障碍型（PIGD）亚型，7例被分类为混合型。此外，纳入5名健康受试者作为健康对照进行评估。与TD患者相比，PIGD患者的LEDD显著更高（431.08±250.90mg对302.08±164.64mg，p=0.034），跌倒次数更多（0.29对0.00，p=0.018）。TD和PIGD患者之间的总体步态障碍以及运动和非运动症状没有显著差异。然而，随着MDS-UPDRSⅢ评分增加，与TD患者相比,PIGD患者的步态障碍指数（GDI）下降（β=-0.730对β=-0.235，p=0.043）以及髋关节屈伸范围下降（β=-0.533对β=-0.470，p<0.001）更为明显。
在PD的早期和中期，TD和PIGD亚型患者的步态严重程度没有显著差异。然而，PIGD患者的步态障碍进展比TD患者更快，尤其影响髋关节活动度。
