Backward compared to forward over ground gait retraining have additional benefits for gait in individuals with mild to moderate Parkinson's disease: A randomized controlled trial
Backward compared to forward over ground gait retraining have additional benefits for gait in individuals with mild to moderate Parkinson's disease: A randomized controlled trial
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DOI：
10.1016/j.gaitpost.2017.08.019
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发表时间：
2017-10-01
期刊：
影响因子：
2.4
通讯作者：
Welman, Karen Estelle
中科院分区：
文献类型：
--
作者：
Grobbelaar, Rone;Venter, Ranel;Welman, Karen Estelle
相反方向的地面步态再训练已被证明对神经康复有益，但尚未在帕金森病（PD）中进行研究。向后行走（BW）可能是一种有用的训练替代方案，以改善PD步态，并可能降低复杂的多方向日常活动中的跌倒风险。主要目的是比较为期八周的前进（FWG）和后退（BWG）步态再训练计划对PD患者步态参数的影响。29名参与者（年龄71.0 +/- 8.8岁; CRYRS-III 38.1 +/- 12.3; H & Y 2.7 +/- 0.5）被随机分配到对照组（FWG; n=14）或实验组（BWG; n=15）。基线测量包括疾病严重程度（SAIRS III）、整体认知（莫卡）和抑郁（PHQ-9）。结果测量是在干预前后评估的10米仪器行走测试（i10 mWT）上选择的步态变量。两组均改善了正常步态速度（FWG：p=0.03，d=0.35; BWG：p < 0.01，d=0.35）和身高标准化步态速度（FWG：p=0.04，d=0.35; BWG：p < 0.01，d=0.57）。此外，BWG表现出步频（p < 0.01，d=0.67）和步长（SL; p=0.02，d=0.39）的改善。两种干预措施都有效地提高了步态速度，足以在社区中独立导航。
Over ground gait retraining in the reverse direction has shown to be beneficial for neurological rehabilitation, but has not yet been investigated in Parkinson's disease (PD). Backwards walking (BW) might be a useful training alternative to improve PD gait and possibly reduce fall risk during complex multi-directional daily activities. The primary aim was to compare the effect of an eight-week forward (FWG) and backwards (BWG) gait retraining program on gait parameters in PD individuals. Twenty-nine participants (aged 71.0 +/- 8.8 years; UPDRS-III 38.1 +/- 12.3; H & Y 2.7 +/- 0.5) were randomly assigned to either the control (FWG; n=14) or experimental group (BWG; n=15). Baseline measures included disease severity (UPDRS III), global cognition (MoCA) and depression (PHQ-9). Outcome measures were selected gait variables on the 10m-instrumented-walk-test (i10mWT) assessed before and after the interventions. Both groups improved usual gait speed (FWG: p=0.03, d=0.35; BWG: p < 0.01, d=0.35) and height-normalized gait speed (FWG: p=0.04, d=0.35; BWG: p < 0.01, d=0.57). Additionally, the BWG demonstrated improved cadence (p < 0.01, d=0.67) and stride length (SL; p=0.02, d=0.39). Both interventions were effective to improved gait speed sufficiently to independently navigate in the community.