Gait and axial postural abnormalities correlations in Parkinson's disease: A multicenter quantitative study.

Autor: Pongmala C; Department of Neuroscience 'Rita Levi Montalcini', University of Turin, Via Cherasco 15, 10124, Turin, Italy; Department of Radiology, University of Michigan, Ann Arbor, USA., Fabbri M; Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network and NeuroToul COEN Center, Toulouse University Hospital, INSERM, University of Toulouse 3, Toulouse, France., Zibetti M; Department of Neuroscience 'Rita Levi Montalcini', University of Turin, Via Cherasco 15, 10124, Turin, Italy., Pitakpatapee Y; Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Wangthumrong T; Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Sangpeamsook T; Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Srikajon J; Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Srivanitchapoom P; Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Youn J; Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea., Cho JW; Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea., Kim M; Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of Korea., Zamil Shinawi HM; National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia., Obaid MT; National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia., Baumann A; Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany., Margraf NG; Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany., Pona-Ferreira F; CNS-Campus Neurológico, Torres Vedras, Portugal., Leitão M; CNS-Campus Neurológico, Torres Vedras, Portugal., Lobo T; CNS-Campus Neurológico, Torres Vedras, Portugal., Ferreira JJ; CNS-Campus Neurológico, Torres Vedras, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Instituto Medicina Molecular João Lobo Antunes, Lisbon, Portugal., Lopiano L; Department of Neuroscience 'Rita Levi Montalcini', University of Turin, Via Cherasco 15, 10124, Turin, Italy., Artusi CA; Department of Neuroscience 'Rita Levi Montalcini', University of Turin, Via Cherasco 15, 10124, Turin, Italy. Electronic address: caartusi@gmail.com.
Jazyk: angličtina
Zdroj: Parkinsonism & related disorders [Parkinsonism Relat Disord] 2022 Dec; Vol. 105, pp. 19-23. Date of Electronic Publication: 2022 Oct 28.
DOI: 10.1016/j.parkreldis.2022.10.026
Abstrakt: Introduction: Gait and axial postural abnormalities (PA) are common and disabling symptoms of Parkinson's disease (PD). The interplay between them has been poorly explored.
Methods: A standardized protocol encompassing videos and photos for posture and gait analysis of PD patients with a clinically defined PA (MDS-UPDRS-III item 3.13 > 0) was used in 6 movement disorder centers. A comprehensive evaluation was performed to clarify the association between gait performance and the presence and severity of PA.
Results: 225 PD patients were enrolled: 57 had severe PA, 149 mild PA, and 19 did not meet criteria for PA, according to a recent consensus agreement on PA definition. PD patients with severe PA were significantly older (p:0.001), with longer disease duration (p:0.007), worse MDS-UPDRS-II and -III scores and axial sub-scores (p < 0.0005), higher LEDD (p:0.002) and HY stage (p < 0.0005), and a significantly lower velocity (p < 0.001) and cadence (p:0.021), if compared to mild PA patients. The multiple regression analysis evaluating gait parameters and degrees of trunk/neck flexion showed that higher degrees of lumbar anterior trunk flexion were correlated with lower step length (OR -0.244; p:0.014) and lower velocity (OR -0.005; p:0.028).
Conclusions: Our results highlight the possible impact of severe anterior trunk flection on PD patients' gait, with a specific detrimental effect on gait velocity and step length. Personalized rehabilitation strategies should be elaborated based on the different features of PA, aiming to target a combined treatment of postural and specifically related gait pattern alterations.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: