短期有氧训练改善帕金森病患者双任务步态功能的预测因素分析

doi:10.3969/j.issn.1006-9771.2026.06.008

Abstract

Abstract:

Objective To construct a prediction model for high responsiveness to short-term aerobic training in patients with Parkinson's disease(PD)based on dual-task gait assessment, and to provide evidence for identifying individuals who are most likely to benefit from such interventions.
Methods A total of 42 patients with PD who visited the outpatient clinic of Tianjin Huanhu Hospital between August 29, 2023 and December 19, 2024 were enrolled. All participants completed a 4-week home-based aerobic cycling training program and underwent dual-task gait assessments pre- and post-training. Patients were classified into high-response group(n=12)and low-response group(n=30)according to whether the improvement in gait speed reached the minimal clinically important difference of 0.1 m/s. The clinical validity of this grouping was verified by comparing differences in cardiopulmonary exercise testing parameters and dual-task gait indicators between the two groups pre- and post-training. Based on baseline characteristics, Firth's penalized maximum likelihood logistic regression was applied to construct a predictive model for high responsiveness, and the discriminative performance of the model was assessed preliminarily.
Results The high-response group showed significantly greater improvement in gait speed, step length, cadence and the anaerobic threshold to maximal oxygen uptake ratio after training compared with the low-response group(P<0.05), confirming the clinical validity of the grouping. The baseline anaerobic threshold to maximal oxygen uptake ratio(OR=3.348), body mass index(OR=2.229)and age(OR=0.428)demonstrated certain discriminative ability in the present sample. The area under the receiver operating characteristic curve was 0.831, with an overall prediction accuracy of 81.0%, specificity of 83.3% and sensitivity of 75.0%. Robustness of the model was confirmed via internal validation using the Bootstrap method, which suggested that the results were informative, but further validation was still required.
Conclusion The anaerobic threshold/maximal oxygen uptake ratio, body mass index and age may predict the response to short-term aerobic training in patients with PD.

Key words: Parkinson's disease, short-term aerobic training, response, regression model, dual-task gait

CLC Number:

R742.5

JIAO Yang, HU Xinru, HOU Weijia, WANG Yue, WANG Jin, YU Yang, ZHU Zhizhong, DONG Ying. Prediction factors of dual-task gait function improvement through short-term aerobic training in patients with Parkinson's disease[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(6): 699-707.

Figures/Tables 6

Table 1

Table 2

Table 3

Comparison of gait spatiotemporal parameters between two groups pre- and post- training"

指标	组别	n	评估	M(Q_L, Q_U)	Z值	P值
步长/m	高应答组	12	前测	1.02(0.96, 1.07)	2.943	0.003
		12	后测	1.08(1.05, 1.13)
	低应答组	30	前测	0.95(0.82, 1.09)	2.541	0.011
		30	后测	0.85(0.78, 1.05)
	治疗前两组差值			0.04(-0.11, 0.22)	0.738	0.460
	治疗后两组差值			0.18(0.08, 0.29)	2.730	0.006
步速/(m·s^-1)	高应答组	12	前测	0.93(0.86, 0.97)	3.020	0.003
		12	后测	1.05(1.02, 1.08)
	低应答组	30	前测	0.88(0.77, 1.01)	1.625	0.104
		30	后测	0.81(0.69, 0.99)
	治疗前两组差值			0.03(-0.07, 0.20)	0.724	0.469
	治疗后两组差值			0.25(0.12, 0.36)	3.901	<0.001
步频/(步·min^-1)	高应答组	12	前测	110.08(108.58, 113.03)	3.020	0.003
		12	后测	117.31(115.30, 120.11)
	低应答组	30	前测	110.40(107.16, 113.52)	2.468	0.014
		30	后测	112.26(106.51, 114.06)
	治疗前两组差值			1.33(-2.83, 7.40)	0.320	0.749
	治疗后两组差值			8.48(5.27, 11.26)	3.968	<0.001
步速不对称度/%	高应答组	12	前测	-1.00(-1.94, -0.51)	0.902	0.367
		12	后测	-0.55(-1.01, -0.27)
	低应答组	30	前测	-0.95(-2.43, 1.14)	1.028	0.304
		30	后测	-0.57(-2.06, 0.41)
	治疗前两组差值			-0.11(-2.42, 1.41)	0.501	0.616
	治疗后两组差值			-0.08(-1.46, 1.61)	0.139	0.889
步长不对称度/%	高应答组	12	前测	-0.97(-2.32, -0.66)	1.509	0.290
		12	后测	-0.56(-1.21, -0.34)
	低应答组	30	前测	-1.33(-2.40, 1.16)	0.679	0.497
		30	后测	-0.91(-2.91, 0.24)
	治疗前两组差值			-0.26(-2.64, 1.70)	0.543	0.587
	治疗后两组差值			0.01(-1.50, 1.05)	0.042	0.967
步频不对称度/%	高应答组	12	前测	0.16(0.02, 0.39)	1.556	0.120
		12	后测	0.01(-0.10, 0.23)
	低应答组	30	前测	0.20(-0.05, 0.50)	1.718	0.086
		30	后测	0.14(-0.21, 0.32)
	治疗前两组差值			-0.12(-0.38, 0.38)	0.056	0.956
	治疗后两组差值			-0.17(-0.39, 0.33)	0.237	0.813

Table 3

Table 4

Table 5

Figure 1

References 39

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组别	n	性别(男/女)/n	年龄/岁	BMI/(kg·m^-2)	病程/年	H-Y分期	MMSE评分
高应答组	12	4/8	61.0(60.0, 62.0)	26.44(25.52, 27.48)	2.0(1.6, 6.0)	1(1, 2)	27.0(26.0, 28.0)
低应答组	30	20/10	68.0(66.0, 72.5)	23.94(21.30, 25.45)	5.0(2.5, 7.0)	2(1, 3)	29.0(26.0, 29.0)
χ²/W值		2.647	263.000	83.000	242.000	255.500	224.500
P值		0.104	0.021	0.007	0.084	0.026	0.209

指标	组别	n	评估	M(Q_L, Q_U)	Z值	P值
静息心率/(次·min^-1)	高应答组	12	前测	86.00(78.00, 90.00)	1.030	0.303
		12	后测	89.00(74.00, 97.00)
	低应答组	30	前测	81.00(72.00, 105.50)	0.620	0.535
		30	后测	87.00(74.00, 93.00)
	治疗前两组差值			5.00(-15.00, 12.75)	0.014	0.989
	治疗后两组差值			2.00(-14.75, 19.25)	0.182	0.856
AT/(mL·kg^-1·min^-1)	高应答组	12	前测	11.95(9.50, 13.03)	2.165	0.030
		12	后测	15.10(12.40, 15.67)
	低应答组	30	前测	13.00(10.80, 13.50)	1.420	0.156
		30	后测	12.55(11.50, 15.20)
	治疗前两组差值			-0.90(-3.38, 1.53)	0.600	0.549
	治疗后两组差值			1.40(-2.60, 3.38)	1.145	0.252
VO₂max/(mL·kg^-1·min^-1)	高应答组	12	前测	12.90(10.47, 14.05)	2.637	0.008
		12	后测	17.00(13.10, 18.50)
	低应答组	30	前测	13.70(12.98, 15.90)	3.932	<0.001
		30	后测	15.85(13.90, 17.60)
	治疗前两组差值			-1.15(-3.47, -0.05)	1.857	0.063
	治疗后两组差值			-1.30(-3.10, 4.05)	0.209	0.834
AT/VO₂max	高应答组	12	前测	0.94(0.89, 0.96)	1.220	0.222
		12	后测	0.87(0.84, 0.94)
	低应答组	30	前测	0.90(0.80, 0.92)	2.573	0.010
		30	后测	0.80(0.75, 0.85)
	治疗前两组差值			0.05(-0.04, 0.13)	1.688	0.091
	治疗后两组差值			0.07(0.00, 0.14)	2.525	0.012

指标	组别	n	评估	M(Q_L, Q_U)	Z值	P值
上肢运动范围/°	高应答组	12	前测	24.14(21.27, 26.25)	2.628	0.009
		12	后测	31.29(29.02, 39.71)
	低应答组	30	前测	28.26(25.83, 45.47)	0.226	0.821
		30	后测	28.03(22.59, 46.10)
	治疗前两组差值			-5.20(-23.41, 3.89)	2.353	0.019
	治疗后两组差值			1.72(-13.96, 16.06)	0.933	0.351
上肢摆动速度/(°·s^-1)	高应答组	12	前测	148.35(130.88, 155.42)	2.706	0.007
		12	后测	187.03(123.61, 207.81)
	低应答组	30	前测	164.97(120.83, 191.84)	0.226	0.821
		30	后测	148.53(111.35, 198.59)
	治疗前两组差值			-13.95(-67.69, 30.29)	1.434	0.152
	治疗后两组差值			20.34(-36.41, 87.35)	1.211	0.226
上肢运动范围不对称度/%	高应答组	12	前测	2.50(-25.26, 69.61)	0.981	0.327
		12	后测	-32.20(-45.99, 36.12)
	低应答组	30	前测	-17.50(-35.13, 29.99)	2.160	0.031
		30	后测	-44.64(-81.76, 15.98)
	治疗前两组差值			21.54(-21.80, 65.72)	0.905	0.366
	治疗后两组差值			40.27(10.76, 75.97)	1.295	0.195
上肢摆动速度不对称度/%	高应答组	12	前测	7.84(-48.24, 17.85)	0.275	0.784
		12	后测	-22.06(-49.84, 11.47)
	低应答组	30	前测	-4.00(-38.82, 35.76)	2.530	0.011
		30	后测	-21.81(-50.80, 11.02)
	治疗前两组差值			6.86(-46.94, 24.42)	0.125	0.900
	治疗后两组差值			10.76(-46.41, 62.10)	0.292	0.770
转身速度/(°·s^-1)	高应答组	12	前测	108.97(106.37, 115.31)	1.765	0.078
		12	后测	114.58(109.91, 122.58)
	低应答组	30	前测	110.27(94.53, 118.60)	0.391	0.696
		30	后测	102.17(94.04, 123.65)
	治疗前两组差值			-1.03(-11.04, 18.18)	0.376	0.707
	治疗后两组差值			14.30(-0.57, 29.82)	1.879	0.060

变量	β	SE	OR(95%CI)	χ²值	P值
截距	-1.201	0.432	0.301(0.107~0.660)	9.810	0.002
AT/VO₂max	1.208	0.588	3.348(1.193~14.862)	5.609	0.018
BMI	0.802	0.379	2.229(1.102~5.273)	5.024	0.025
年龄	-0.849	0.412	0.428(0.172~0.962)	4.214	0.040

Prediction factors of dual-task gait function improvement through short-term aerobic training in patients with Parkinson's disease

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