《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (3): 339-344.doi: 10.3969/j.issn.1006-9771.2024.03.012
收稿日期:
2023-11-16
修回日期:
2024-02-06
出版日期:
2024-03-25
发布日期:
2024-04-01
通讯作者:
刘颖
E-mail:kite_liu@sina.com
作者简介:
葛颖(1999-),女,汉族,江西赣州市人,硕士研究生,主要研究方向:帕金森病康复。基金资助:
GE Ying, ZHAO Wowa, ZHANG Lu, SHU Xuan, LI Jiawei, LIU Ying()
Received:
2023-11-16
Revised:
2024-02-06
Published:
2024-03-25
Online:
2024-04-01
Contact:
LIU Ying
E-mail:kite_liu@sina.com
Supported by:
摘要:
目的 观察伴或不伴冻结步态的早中期帕金森病患者运动功能和生活质量的差异,分析冻结步态与患者运动功能和生活质量的相关性。
方法 2021年4月至2022年12月,在北京协和医学院门诊选取60~80岁早中期帕金森病患者132例,根据是否并发冻结步态分为冻结步态组(n = 43)和非冻结步态组(n = 89)。采用冻结步态问卷(FOGQ)、Berg平衡量表(BBS)、计时起立-行走测试(TUGT)、5次起坐试验(FTSST)、等速肌力测试、统一帕金森病评分量表(UPDRS)和39项帕金森病生活质量问卷(PDQ-39)进行评定。
结果 冻结步态组BBS评分小于非冻结步态组(Z = -2.354, P < 0.05),TUGT、FTSST、UPDRS第二和第三部分评分以及帕金森病生活质量指数(PDSI)明显大于非冻结步态组(Z > 3.074, t = 2.748, P < 0.01)。FOGQ评分与BBS、UPDRS第二和第三部分评分,以及PDSI显著相关(|r| > 0.392, P < 0.001)。
结论 冻结步态的发生影响早中期帕金森病患者的运动功能、日常生活活动能力和生活质量,增加跌倒风险。
中图分类号:
葛颖, 赵沃娃, 张路, 舒璇, 李佳蔚, 刘颖. 帕金森病伴冻结步态患者的运动功能和生活质量[J]. 《中国康复理论与实践》, 2024, 30(3): 339-344.
GE Ying, ZHAO Wowa, ZHANG Lu, SHU Xuan, LI Jiawei, LIU Ying. Motor function and quality of life in Parkinson's disease patients with freezing of gait[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(3): 339-344.
表1
两组年龄和运动功能比较"
变量 | 非冻结步态组(n = 89) | 冻结步态组(n = 43) | t/Z值 | P值 |
---|---|---|---|---|
年龄/岁 | 68.72±7.00 | 69.78±5.90 | -0.847 | 0.398 |
BBS评分 | 45 (42, 51) | 43 (39, 48) | -2.354 | 0.019 |
TUGT/s | 10.6 (8.5, 12.9) | 13 (9.9, 18.0) | 3.074 | 0.002 |
FTSST/s | 11.7 (9.3, 15.1) | 14.7 (11.8, 18.2) | 3.457 | 0.001 |
膝屈曲最大峰值力矩/(N·m) | 15.5 (11.3, 21.5) | 12.5 (9.5, 20.5) | -1.649 | 0.099 |
膝伸展最大峰值力矩/(N·m) | 32 (23, 39.5) | 29.5 (19, 41) | -0.877 | 0.381 |
UPDRS第二部分评分 | 14 (10, 17.5) | 19 (16, 25) | 5.418 | < 0.001 |
UPDRS第三部分评分 | 20.75±8.83 | 25.98±9.79 | 2.748 | 0.003 |
表2
两组PDSI及PDQ-39各维度分比较"
变量 | 非冻结步态组(n = 89) | 冻结步态组(n = 43) | t/Z值 | P值 |
---|---|---|---|---|
PDSI | 14.48 (8.34, 22.94) | 29.11 (16.88, 39.79) | 4.618 | < 0.001 |
身体活动 | 10 (5, 37.5) | 40 (22.5, 70) | 4.681 | < 0.001 |
ADL | 4.17 (0, 16.67) | 25 (12.5, 41.67) | 4.835 | < 0.001 |
精神健康 | 8.33 (0, 20.83) | 20.83 (8.33, 41.67) | 3.491 | < 0.001 |
病耻感 | 12.5 (0, 37.5) | 25 (0, 56.25) | 1.482 | 0.138 |
社会支持 | 0 (0, 0) | 0 (0, 25) | 3.098 | 0.002 |
认知 | 18.75 (6.25, 31.25) | 25 (12.5, 43.75) | 2.751 | 0.006 |
交流 | 0 (0, 16.67) | 16.67 (0, 41.67) | 2.802 | 0.005 |
身体不适 | 33.33 (16.67, 41.67) | 41.67 (16.67, 50) | 1.821 | 0.069 |
[1] |
BEITZ J M. Parkinson's disease: a review[J]. Front Biosci (Schol Ed), 2014, 6(1): 65-74.
doi: 10.2741/s415 pmid: 24389262 |
[2] |
QI S, YIN P, WANG L, et al. Prevalence of Parkinson's disease: a community-based study in China[J]. Mov Disord, 2021, 36(12): 2940-2944.
doi: 10.1002/mds.v36.12 |
[3] |
NUTT J G, BLOEM B R, GILADI N, et al. Freezing of gait: moving forward on a mysterious clinical phenomenon[J]. Lancet Neurol, 2011, 10(8): 734-744.
doi: 10.1016/S1474-4422(11)70143-0 pmid: 21777828 |
[4] |
KONDO Y, MIZUNO K, BANDO K, et al. Measurement accuracy of freezing of gait scoring based on videos[J]. Front Hum Neurosci, 2022, 16: 828355.
doi: 10.3389/fnhum.2022.828355 |
[5] |
GE H L, CHEN X Y, LIN Y X, et al. The prevalence of freezing of gait in Parkinson's disease and in patients with different disease durations and severities[J]. Chin Neurosurg J, 2020, 6: 17.
doi: 10.1186/s41016-020-00197-y |
[6] |
OU R, GUO X, SONG W, et al. Freezing of gait in Chinese patients with Parkinson disease[J]. J Neurol Sci, 2014, 345(1-2): 56-60.
doi: 10.1016/j.jns.2014.07.002 pmid: 25043665 |
[7] |
TAXIMAIMAITI R, WANG X P. Comparing the clinical and neuropsychological characteristics of Parkinson's disease with and without freezing of gait[J]. Front Neurosci, 2021, 15: 660340.
doi: 10.3389/fnins.2021.660340 |
[8] |
ZHANG F, SHI J, DUAN Y, et al. Clinical features and related factors of freezing of gait in patients with Parkinson's disease[J]. Brain Behav, 2021, 11(11): e2359.
doi: 10.1002/brb3.2359 pmid: 34551452 |
[9] | 中华医学会神经病学分会帕金森病及运动障碍学组,中国医师协会神经内科医师分会帕金森病及运动障碍专业. 中国帕金森病的诊断标准(2016版)[J]. 中华神经科杂志, 2016, 4: 268-271. |
[10] |
GILADI N, SHABTAI H, SIMON E S, et al. Construction of Freezing of Gait Questionnaire for patients with Parkinsonism[J]. Parkinsonism Relat Disord, 2000, 6(3): 165-170.
doi: 10.1016/S1353-8020(99)00062-0 |
[11] |
TAO P, SHAO X, ZHUANG J, et al. Translation, cultural adaptation, and reliability and validity testing of a Chinese Version of the Freezing of Gait Questionnaire (FOGQ-CH)[J]. Front Neurol, 2021, 12: 760398.
doi: 10.3389/fneur.2021.760398 |
[12] | 杨雅琴, 周亚楠, 邢德利, 等. Berg平衡量表应用于帕金森病患者的信度分析[J]. 中国康复理论与实践, 2016, 22(3): 303-305. |
YANG Y Q, ZHOU Y N, XING D L, et al. Reliability of Berg Balance Scale in patients with Parkinson's disease[J]. Chin J Rehabil Theory Pract, 2016, 22(3): 303-305. | |
[13] |
LIMA C A, RICCI N A, NOGUEIRA E C, et al. The Berg Balance Scale as a clinical screening tool to predict fall risk in older adults: a systematic review[J]. Physiotherapy, 2018, 104(4): 383-394.
doi: S0031-9406(18)30032-4 pmid: 29945726 |
[14] | NIGHTINGALE C J, MITCHELL S N, BUTTERFIELD S A. Validation of the Timed Up and Go Test for assessing balance variables in adults aged 65 and older[J]. J Aging Phys Act, 2019, 27(2): 230-233. |
[15] |
ALBALWI A A, ALHARBI A A. Optimal procedure and characteristics in using Five Times Sit to Stand Test among older adults: a systematic review[J]. Medicine (Baltimore), 2023, 102(26): e34160.
doi: 10.1097/MD.0000000000034160 |
[16] |
HASAN S, KANDASAMY G, ALYAHYA D, et al. Effect of resisted sprint and plyometric training on lower limb functional performance in collegiate male football players: a randomised control trial[J]. Int J Environ Res Public Health, 2021, 18(13): 6702.
doi: 10.3390/ijerph18136702 |
[17] |
RAMSAY N, MACLEOD A D, ALVES G, et al. Validation of a UPDRS-/MDS-UPDRS-based definition of functional dependency for Parkinson's disease[J]. Parkinsonism Relat Disord, 2020, 76: 49-53.
doi: 10.1016/j.parkreldis.2020.05.034 |
[18] |
MARTINEZ-MARTIN P, RODRIGUEZ-BLAZQUEZ C, MARIO A, et al. Parkinson's disease severity levels and MDS-Unified Parkinson's Disease Rating Scale[J]. Parkinsonism Relat Disord, 2015, 21(1): 50-54.
doi: 10.1016/j.parkreldis.2014.10.026 |
[19] |
GOETZ C G, TILLEY B C, SHAFTMAN S R, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results[J]. Mov Disord, 2008, 23(15): 2129-2170.
doi: 10.1002/mds.v23:15 |
[20] |
BUSHNELL D M, MARTIN M L. Quality of life and Parkinson's disease: translation and validation of the US Parkinson's Disease Questionnaire (PDQ-39)[J]. Qual Life Res, 1999, 8(4): 345-350.
pmid: 10472167 |
[21] |
SNIJDERS A H, TAKAKUSAKI K, DEBU B, et al. Physiology of freezing of gait[J]. Ann Neurol, 2016, 80(5): 644-659.
doi: 10.1002/ana.24778 pmid: 27649270 |
[22] |
FALLA M, COSSU G, DI FONZO A. Freezing of gait: overview on etiology, treatment, and future directions[J]. Neurol Sci, 2022, 43(3): 1627-1639.
doi: 10.1007/s10072-021-05796-w pmid: 35028778 |
[23] |
GAVRILIUC O, PASCHEN S, ANDRUSCA A, et al. Clinical patterns of gait freezing in Parkinson's disease and their response to interventions: an observer-blinded study[J]. Parkinsonism Relat Disord, 2020, 80: 175-180.
doi: 10.1016/j.parkreldis.2020.09.043 |
[24] |
KWOK J Y Y, SMITH R, CHAN L M L, et al. Managing freezing of gait in Parkinson's disease: a systematic review and network meta-analysis[J]. J Neurol, 2022, 269(6): 3310-3324.
doi: 10.1007/s00415-022-11031-z |
[25] |
COSENTINO C, BACCINI M, PUTZOLU M, et al. Effectiveness of physiotherapy on freezing of gait in Parkinson's disease: a systematic review and meta-analyses[J]. Mov Disord, 2020, 35(4): 523-536.
doi: 10.1002/mds.v35.4 |
[26] |
KORKUSUZ S, SECKINOGULLARI B, OZCAN A, et al. Effects of freezing of gait on balance in patients with Parkinson's disease[J]. Neurol Res, 2023, 45(5): 407-414.
doi: 10.1080/01616412.2022.2149510 |
[27] |
LINDHOLM B, HAGELL P, HANSSON O, et al. Prediction of falls and/or near falls in people with mild Parkinson's disease[J]. PLoS One, 2015, 10(1): e0117018.
doi: 10.1371/journal.pone.0117018 |
[28] |
LOPES L K R, SCIANNI A A, LIMA L O, et al. The Mini-BESTest is an independent predictor of falls in Parkinson disease[J]. Braz J Phys Ther, 2020, 24(5): 433-440.
doi: 10.1016/j.bjpt.2019.07.006 pmid: 31377123 |
[29] |
DURMUS B, BAYSAL O, ALTINAYAR S, et al. Lower extremity isokinetic muscle strength in patients with Parkinson's disease[J]. J Clin Neurosci, 2010, 17(7): 893-896.
doi: 10.1016/j.jocn.2009.11.014 pmid: 20435478 |
[30] |
YOKOTE A, HAYASHI Y, YANAMOTO S, et al. Leg muscle strength correlates with gait performance in advanced Parkinson disease[J]. Intern Med, 2022, 61(5): 633-638.
doi: 10.2169/internalmedicine.7646-21 |
[31] |
AKTURK T, GUVEN H, GUVEN B, et al. Association of freezing of gait and clinical features in patients with Parkinson's disease[J]. Acta Neurol Belg, 2021, 121(1): 153-159.
doi: 10.1007/s13760-019-01217-0 |
[32] | BOCK M A, BROWN E G, ZHANG L, TANNER C. Association of motor and nonmotor symptoms with health-related quality of life in a large online cohort of people with Parkinson disease[J]. Neurology, 2022, 98(22): e2194-e2203. |
[33] |
PEREZ-LLORET S, NEGRE-PAGES L, DAMIER P, et al. Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease[J]. JAMA Neurol, 2014, 71(7): 884-890.
doi: 10.1001/jamaneurol.2014.753 |
[34] |
RUTZ D G, BENNINGER D H. Physical therapy for freezing of gait and gait impairments in Parkinson disease: a systematic review[J]. PM R, 2020, 12(11): 1140-1156.
doi: 10.1002/pmrj.v12.11 |
[35] |
SCHOLL J L, ESPINOZA A I, RAI W, et al. Relationships between freezing of gait severity and cognitive deficits in Parkinson's disease[J]. Brain Sci, 2021, 11(11): 1496.
doi: 10.3390/brainsci11111496 |
[36] |
MONAGHAN A S, GORDON E, GRAHAM L, et al. Cognition and freezing of gait in Parkinson's disease: a systematic review and meta-analysis[J]. Neurosci Biobehav Rev, 2023, 147: 105068.
doi: 10.1016/j.neubiorev.2023.105068 |
[37] |
WALTON C C, MOWSZOWSKI L, GILAT M, et al. Cognitive training for freezing of gait in Parkinson's disease: a randomized controlled trial[J]. NPJ Parkinsons Dis, 2018, 4: 15.
doi: 10.1038/s41531-018-0052-6 pmid: 29796409 |
[38] |
KING L A, MANCINI M, SMULDERS K, et al. Cognitively challenging agility boot camp program for freezing of gait in Parkinson disease[J]. Neurorehabil Neural Repair, 2020, 34(5): 417-427.
doi: 10.1177/1545968320909331 pmid: 32249668 |
[39] |
PARDOEL S, KOFMAN J, NANTEL J, et al. Wearable-sensor-based detection and prediction of freezing of gait in Parkinson's disease: a review[J]. Sensors (Basel), 2019, 19(23): 5141.
doi: 10.3390/s19235141 |
[40] |
HOOPS S, NAZEM S, SIDEROWF A D, et al. Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease[J]. Neurology, 2009, 73(21): 1738-1745.
doi: 10.1212/WNL.0b013e3181c34b47 pmid: 19933974 |
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