早中期帕金森病患者平衡功能、跌倒风险及步态分析

摘要

目的 分析早中期帕金森病患者平衡功能、跌倒风险和步态,以为其康复治疗提供临床依据.方法 共30例早中期帕金森病患者和15例性别、年龄、受教育程度相匹配的正常对照者采用Berg平衡量表(BBS)评价平衡功能,起立-行走计时测验(TUGT)、站起测验(CRT)和走直线步态测验(TGT)评价跌倒风险,步态分析系统分析步态.结果 与对照组相比,帕金森病组患者BBS评分减少(P=0.001)、TUGT时间(P=0.003)和CRT时间(P=0.002)延长、TGT正确步数减少(P=0.041),以及10米步行试验之步长缩短(P=0.020)、步速减慢(P=0.038)、足尖着地比例增加(P=0.000)、摆动相左侧和右侧踝背屈角度减小(P=0.005,0.006).结论 早中期帕金森病患者平衡功能下降、跌倒风险和步态异常风险增加,应早期予康复治疗.%Objective To analyze the balance function,falling risk and gait in the early and middle stages of patients with Parkinson's disease (PD) for provide clinical basis for patients' rehabilitation treatment.Methods There were 30 PD patients in the early and middle stages and 15 healthy subjects matched in gender,age and degree of education.Berg Balance Scale (BBS) was used to evaluate balance function.Timed Up and Go Test (TUGT),Chair Rising Test (CRT) and Tandem Gait Test (TGT) were used to evaluate falling risk.The gait analysis system was used to evaluate gait.Results Compared with healhy subjects,PD patients obtained lower scores on BBS (P =0.001).In the falling risk,PD patients spent more seconds in performing TUGT (P =0.003) and CRT (P =0.002) and finished fewer numbers of steps on TGT (P =0.041).In 10-Meter Walk Test (10MWT),PD patients had shorter step length (P=0.020),decreased step speed (P =0.038),increased ratio of toe touches (P =0.000) and decreased left and right ankle dorsiflexion in swing phase (P =0.005,0.006).Conclusions In the early and middle stages,PD patients have decreased balance function,increased falling risk and unusual gait.The rehabilitation treatment should be given as soon as possible.