摘要
目的探讨可用于评估帕金森病(PD)伴冻结步态(FOG)患者美多芭负荷试验的可穿戴设备运动参数。方法纳入2020年9月~2021年1月收治于华中科技大学附属协和医院神经内科具有FOG的帕金森综合征患者28例,根据是否符合PD临床诊断标准或明确诊断为PD将其分为PD-FOG组(18例)和非PD-FOG组(10例)。对所有患者行美多芭负荷试验并采用统一的帕金森病评定量表第三部分(UPDRS-Ⅲ)在负荷试验前(关期)、后(开期)进行评分,使用可穿戴设备采集负荷试验前、后PD-FOG组患者人体运动姿态的时空、动力学和运动学参数并进行比较。采用Pearson相关分析评估UPDRS-Ⅲ评分与可穿戴设备运动参数的相关性。结果两组患者开期评分均较同组关期评分显著降低(P<0.05)。PD-FOG组关期评分、UPDRS-Ⅲ期评分改变量及改善率均高于非PD-FOG组(P<0.05)。与负荷试验前比较,PD伴FOG患者负荷试验后行走过程中的左右小腿角速度峰值、腰部矢状面角度最小值、腰部矢状面角度最大值、严重侧小腿角速度峰值及转向过程中的峰值角速度均增加,左右腿摆动相相对偏差及左右腿支撑相相对偏差均减少(P<0.05)。Pearson相关分析结果显示,PD伴FOG患者起立过程中的躯干矢状面峰值角速度,行走过程中左右小腿角速度峰值、严重侧小腿角速度峰值及转向过程中的峰值角速度与UPDRS-Ⅲ评分均呈负相关(P<0.05)。结论可穿戴设备的运动参数与临床UPDRS-Ⅲ评分具有较好的相关性,相应的运动参数可反映PD伴FOG患者美多芭负荷试验前、后的运动功能改变。
Objective To explore parameters of the wearable device used to evaluate madopa challenge test in Parkinson’s disease patients with freezing of gait.Methods A total of 28 Parkinson syndrome patients with freezing of gait who were treated in the Department of Neurology,Union Hospital of Huazhong University of Science and Technology from September 2020 to January 2021 were concluded.According to whether they met the clinical diagnostic criteria for PD or were definitely diagnosed as PD,they were divided into PD-FOG group(18 cases)and Non-PD-FOG group(10 cases).The madopa challenge test and UPDRS-Ⅲscore were performed on all patients before and after the challenge test.The wearable device collected the patient’s data under the time up and go and turning tests before and after the levodopa challenge test.Wearable equipment was used to collect and compare the spatiotemporal,dynamic and kinematic parameters of human motion posture of PD patients with FOG before and after the challenge test.Pearson correlation analysis was used to evaluate the correlation between UPDRS-Ⅲscore and the exercise parameters of wearable devices.Results The scores of patients in both groups in on-period were significantly lower than those in off-period of the same group(P<0.05).Score on off-period,the change and improvement rate of UPDRS-Ⅲscore in PD-FOG group were higher than those in Non-PD-FOG group(P<0.05).Compared with that before the challenge test,the peak angular velocity of left and right legs,the minimum waist sagittal plane angle,the maximum waist sagittal plane angle,the peak angular velocity of severe side legs and the mid peak angular velocity during the steering process of PD patients with FOG during walking increased,and the relative deviation of swing phase of left and right legs and the relative deviation of support phase of left and right legs decreased(P<0.05).Pearson correlation analysis showed that the peak angular velocity of the trunk sagittal plane,left and right crus during walking,the peak angular velocity of the severe side crus during walking,and the peak angular velocity during turning were negatively correlated with the UPDRS-Ⅲscore(P<0.05).Conclusion The parameters of the wearable device has a good correlation with the clinical UPDRS-Ⅲscale,which can reflect the changes of motor symptoms before and after the challenge test in PD patients with FOG.
作者
张新凯
高萌
徐岩
朱红灿
曹学兵
Zhang Xinkai;Gao Meng;Xu Yan;Zhu Hongcan;Cao Xuebing(Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;不详)
出处
《临床内科杂志》
CAS
2022年第9期606-609,共4页
Journal of Clinical Internal Medicine
基金
国家重点研发计划(2017YFC1310300)
国家自然科学基金资助项目(81171193、81671108、81873734)
关键词
帕金森病伴冻结步态
可穿戴设备
美多芭负荷试验
定量评估
Freezing of gait in Parkinson’s disease
Wearable device
Madopa challenge test
Quantitative evaluation
作者简介
通讯作者:朱红灿,E-mail:zhc660407@hotmail.com;通讯作者:曹学兵,E-mail:caoxuebing@126.com
