帕金森病伴冻结步态患者的运动功能和生活质量

doi:10.3969/j.issn.1006-9771.2024.03.012

《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

帕金森病伴冻结步态患者的运动功能和生活质量

葛颖, 赵沃娃, 张路, 舒璇, 李佳蔚, 刘颖()

中国医学科学院北京协和医院康复医学科，北京市 100730

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。
刘颖(1971-)，女，汉族，山东人，医学博士，主任医师、教授，主要研究方向：帕金森病、淋巴水肿、老年病和罕见病的康复。
基金资助:
北京市科技委员会老龄科技服务创新能力提升项目(Z191100004419009)

Motor function and quality of life in Parkinson's disease patients with freezing of gait

GE Ying, ZHAO Wowa, ZHANG Lu, SHU Xuan, LI Jiawei, LIU Ying()

Department of Rehabilitation, Peking Union Medical College Hospital, Beijing 100730, China

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:
Beijing Municipal Science and Technology Commission Service Innovation for the Elderly(Z191100004419009)

摘要/Abstract

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。

关键词: 帕金森病, 冻结步态, 运动, 生活质量

Abstract:

Objective To observe the differences in motor function and quality of life among mild-to-moderate Parkinson's disease (PD) patients with or without freezing of gait (FOG), and the correlation of FOG to motor function and quality of life.

Methods From April, 2021 to December, 2022, 132 mild-to-moderate PD patients aged 60 to 80 years were selected from Peking Union Medical College Hospital, and were divided into FOG group (n = 43) and non-FOG group (n = 89) according to the clinical features. They were assessed with Freezing of Gait Questionnaire (FOGQ), Berg Balance Scale (BBS), Timed "Up & Go" Test (TUGT), Five Times Sit to Stand Test (FTSST), isokinetic muscle strength, Unified Parkinson's Disease Rating Scale (UPDRS) and 39-item Parkinson's Disease Questionaire-39 (PDQ-39).

Results The BBS score was lower (Z = -2.354, P < 0.05), and the TUGT, FTSST, UPDRS part 2 and part 3 scores, and the Parkinson's disease summary index (PDSI) were higher in FOG group than in non-FOG group (Z > 3.074, t = 2.748, P < 0.01). FOGQ score correlated with BBS score, UPDRS Part 2 and Part 3 scores, and PDSI (|r| > 0.392, P < 0.001).

Conclusion FOG would impair motor function, activities of daily living and quality of life in mild-to-moderate PD patients, and increase the risk of falls.

Key words: Parkinson's disease, freezing of gait, motor, quality of life

中图分类号:

R742.5

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.

图/表 3

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参考文献 40

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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

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

自变量	未控制性别和年龄		控制性别和年龄
自变量	r值	P值	r值	P值
BBS评分	-0.466	< 0.001	-0.448	< 0.001
UPDRS第二部分评分	0.657	< 0.001	0.601	< 0.001
UPDRS第三部分评分	0.467	< 0.001	0.392	< 0.001
PDSI	0.641	< 0.001	0.560	< 0.001

帕金森病伴冻结步态患者的运动功能和生活质量

Motor function and quality of life in Parkinson's disease patients with freezing of gait

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