Palliyath S, Hallett M, Thomas S L, Lebiedowska M K
Veterans' Administration Medical Center, New Orleans, Louisiana, USA.
Mov Disord. 1998 Nov;13(6):958-64. doi: 10.1002/mds.870130616.
The gait pattern in 10 patients with cerebellar degenerations was studied and the results were compared with 10 matched normal subjects, seeking the principal patterns in this disorder. Gait at natural speed was studied in a biomechanics laboratory using a video-based kinematic data acquisition system for measuring body movements. Patients showed a reduced step and stride length with a trend to reduced cadence. Heel off time, toe off time, and time of peak flexion of the knee in swing were all delayed. Range of motion of ankle, knee, and hip were all reduced, but only ankle range of motion reached significance. Multijoint coordination was impaired, as indicated by a relatively greater delay of plantar flexion of the ankle compared with flexion of the knee and a relatively late knee flexion compared with hip flexion at the onset of swing. The patients also showed increased variability of almost all measures. Although some of the deviations from normal were simply the result of slowness of walking, the gait pattern of patients with cerebellar degeneration shows incoordination similar to that previously described for their multijoint limb motion.
对10例小脑退行性变患者的步态模式进行了研究,并将结果与10名匹配的正常受试者进行比较,以探寻这种疾病的主要模式。在生物力学实验室中,使用基于视频的运动学数据采集系统来测量身体运动,研究自然速度下的步态。患者的步幅和步长减小,步频有降低趋势。足跟离地时间、足趾离地时间以及摆动期膝关节最大屈曲时间均延迟。踝关节、膝关节和髋关节的活动范围均减小,但只有踝关节活动范围达到显著水平。多关节协调性受损,表现为与膝关节屈曲相比,踝关节跖屈延迟相对更大,且在摆动开始时,与髋关节屈曲相比,膝关节屈曲相对较晚。患者几乎所有测量指标的变异性也增加。尽管一些与正常情况的偏差仅仅是行走缓慢的结果,但小脑退行性变患者的步态模式显示出不协调,类似于之前描述的其多关节肢体运动的不协调。