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Proposal of a new conceptual gait model for patients with Parkinson’s disease based on factor analysis

机译:基于因子分析的帕金森病患者新概念步态模型的提议

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摘要

Abstract Background Gait impairment is a risk factor for falls in patients with Parkinson’s disease (PD). Gait can be conveniently assessed by electronic walkways, but there is need to select which spatiotemporal gait variables are useful for assessing gait in PD. Existing models for gait variables developed in healthy subjects and patients with PD show some methodological shortcomings in their validation through exploratory factor analysis (EFA), and were never confirmed by confirmatory factor analysis (CFA). The aims of this study were (1) to create a new model of gait for PD through EFA, (2) to analyze the factorial structure of our new model and compare it with existing models through CFA. Results From the 37 variables initially considered in 250 patients with PD, 10 did not show good-to-excellent reliability and were eliminated, while further 19 were eliminated after correlation matrix and Kaiser–Meyer–Olkin measure. The remaining eight variables underwent EFA and three factors emerged: pace/rhythm, variability, and asymmetry. Structural validity of our new model was then examined with CFA, using the structural equation modeling. After some modifications, suggested by the Modification Indices, we obtained a final model that showed an excellent fit. In contrast, when the structure of previous models of gait was analyzed, no model achieved convergence with our sample of patients. Conclusions Our model for spatiotemporal gait variables of patients with PD is the first to be developed through an accurate EFA and confirmed by CFA. It contains eight gait variables divided into three factors and shows an excellent fit. Reasons for the non-convergence of other models could be their inclusion of highly inter-correlated or low-reliability variables or could be possibly due to the fact that they did not use more recent methods for determining the number of factors to extract.
机译:摘要背景步态损伤是帕金森病(PD)患者跌落的危险因素。可以通过电子人行道方便地评估步态,但需要选择哪种时空步态变量对于评估PD中的步态有用。在健康受试者和PD患者中开发的现有模型和PD患者通过探索因子分析(EFA)显示了一些方法论缺点,并且从未通过确认因子分析(CFA)确认。本研究的目的是(1)通过EFA,(2)创建PD的新型步态模型,以分析我们新模型的因子结构,并通过CFA与现有模型进行比较。最初在250名PD患者中考虑的37个变量的结果没有表现出良好的可靠性,并且被淘汰,而相关矩阵和Kaiser-Meyer-Olkin测量后,则消除了19。剩下的八个变量接受了EFA和出现了三种因素:节奏/节奏,可变性和不对称性。然后使用结构方程模型与CFA检查我们新模型的结构有效性。经过一些修改,修改指标建议,我们获得了最终模型,该模型显示出优异的合适。相比之下,当分析先前的步态模型的结构时,没有模型与我们的患者样本实现会聚。结论我们第一个通过精确的EFA开发的PD患者的时空步态变量模型,并由CFA确认。它包含八个步态变量分为三个因素,并显示出优异的合适。其他模型的非收敛原因可能包括高度相关或低可靠性变量,或者可能是可能的,因为它们没有使用更新的方法来确定提取的因素的数量。

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