帕金森病跌倒与非跌倒者平衡评估及步态分析结果比较
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摘要
目的:探讨帕金森病跌倒与非跌倒者平衡评估及步态分析结果差异,为康复治疗提供临床依据。方法:将帕金森病患者32例,据其是否有跌倒史分为跌倒组15例和非跌倒组17例,比较2组平衡评估及步态分析各项参数结果差异。结果:同非跌倒组比较,跌倒组患者平均/最大轨迹误差更大、单足支撑时间更短、摆动相踝背屈角度更小(P<0.05)。结论:帕金森病康复训练中应强调本体感觉、肌力、单侧下肢负重、步态方面的训练,以降低患者跌倒风险。
Objective:To investigate the differences of balance evaluation and gait analysis parameters of fall and non-fall patients with Parkinson's disease(PD)for providing clinical basis for patients' rehabilitation treatment.Methods:The clinic attendants with(PD)from January 2016 to November 2017 were divided into fall group and non-fall group according to the history of falling down.Differences in parameters of balance evaluation and gait analysis were analyzed.Results:Thirty-two patients were included,with 15 cases in fall group,and 17 cases in non-fall group.The average/maximum trajectory errors were significantly higher,the average time of single foot support accounting for the percentage of walking time was significantly shorter,and the right ankle dorsiflexion in swing phase was significantly lower in fall group than in non-fall group(P<0.05).Conclusion:Rehabilitation training according to proprioception,muscle strength and correct gait should be emphasized to decrease falling risk of PD patients.
Objective:To investigate the differences of balance evaluation and gait analysis parameters of fall and non-fall patients with Parkinson's disease(PD)for providing clinical basis for patients' rehabilitation treatment.Methods:The clinic attendants with(PD)from January 2016 to November 2017 were divided into fall group and non-fall group according to the history of falling down.Differences in parameters of balance evaluation and gait analysis were analyzed.Results:Thirty-two patients were included,with 15 cases in fall group,and 17 cases in non-fall group.The average/maximum trajectory errors were significantly higher,the average time of single foot support accounting for the percentage of walking time was significantly shorter,and the right ankle dorsiflexion in swing phase was significantly lower in fall group than in non-fall group(P<0.05).Conclusion:Rehabilitation training according to proprioception,muscle strength and correct gait should be emphasized to decrease falling risk of PD patients.
引文
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[11]Protas EJ,Mitchell K,Williams A,et al.Gait and step training to reduce falls in Parkinson's disease[J].NeuroRehabilitation,2005,20(3):183-190.
[12]Fasano A,Canning CG,Hausdorff JM,et al.Falls in Parkinson’s Disease:A Complex and Evolving Picture[J].Mov Disord,2017,32(11):1524-1536.
[13]王盛,杨菊,朱奕,等.平衡反馈训练仪用于脑损伤偏瘫患者静态平衡测试的信度与效度研究[J].中国康复医学杂志,2011,26(11):1035-1038.
[14]Bekkers EMJ,Hooqkamer W,Benqevoord A,et al.Freezing-related perception deficits of asymmetrical walking in Parkinson's disease.Neuroscience,2017,364:122-129.
[15]婷婷,董晓梅,王声滂.老年人跌倒后心理障碍及其影响因素分析[J].中华流行病学杂志,2010,31(10):1098-1102.
[16]Canning CG,Sherrington C,Lord SR,et al.Exercise for falls prevention in Parkinson disease[J].Neurology,2015,84(3):304-312.
[2] Kempster PA,Williams DR,Selikhova M,et al.Patterns of levodopa response in Parkinson’s disease:a clinico-pathological study[J].Brain,2007,130(Pt 8):2123-2128.
[3] Thurman DJ,Stevens JA,Rao JK.Quality Standards Subcommittee of the American Academy of Neurology.Practice parameter:assessing patients in a neurology practice for risk of falls(an evidence-based review):report of the Quality Standards Subcommittee of the American Academy of Neurology[J].Neurology,2008,70(6):473-479.
[4] Li F,Harmer P,Fitzgerald K,et al.Tai chi and postural stability in patients with Parkinson’s disease[J].N Engl J Med,2012,366(6):511-519.
[5] Morris ME,Menz HB,McGinley JL,et al.A randomized controlled trial to reduce falls in people with Parkinson’s disease[J].Neurorehabil Neural Repair,2015,29(8):777-785.
[6] Canning CG,Sherrington C,Lord SR,et al.Exercise for falls prevention in Parkinson disease:a randomized controlled trial[J].Neurology,2015,84(3):304-312.
[7] Goodwin VA,Richards SH,Henley W,et al.An exercise intervention to prevent falls in people with Parkinson’s disease:a pragmatic randomised controlled trial[J].J Neurol Neurosurg Psychiatry,2011,82(11):1232-1238.
[8] Gibson M J ARO,Isaacs B,et al.The prevention of falls in later life.A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly[J].Dan Med Bull,1987,34(Suppl 4):1-24.
[9] Wrisley DM,Kumar NA.Functional gait assessment:concurrent,discriminative,and predictive validity in community-dwelling older adults[J].Phys Ther,2010,90(5):761-773.
[10]Hirsch MA,Toole T,Maitland CG,et al.The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease[J].Arch Phys Med Rehabil,2003,84(8):1109-1117.
[11]Protas EJ,Mitchell K,Williams A,et al.Gait and step training to reduce falls in Parkinson's disease[J].NeuroRehabilitation,2005,20(3):183-190.
[12]Fasano A,Canning CG,Hausdorff JM,et al.Falls in Parkinson’s Disease:A Complex and Evolving Picture[J].Mov Disord,2017,32(11):1524-1536.
[13]王盛,杨菊,朱奕,等.平衡反馈训练仪用于脑损伤偏瘫患者静态平衡测试的信度与效度研究[J].中国康复医学杂志,2011,26(11):1035-1038.
[14]Bekkers EMJ,Hooqkamer W,Benqevoord A,et al.Freezing-related perception deficits of asymmetrical walking in Parkinson's disease.Neuroscience,2017,364:122-129.
[15]婷婷,董晓梅,王声滂.老年人跌倒后心理障碍及其影响因素分析[J].中华流行病学杂志,2010,31(10):1098-1102.
[16]Canning CG,Sherrington C,Lord SR,et al.Exercise for falls prevention in Parkinson disease[J].Neurology,2015,84(3):304-312.