Freezing of gait: a practical approach to management
Freezing of gait: a practical approach to management
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DOI：
10.1016/s1474-4422(15)00041-1
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发表时间：
2015-07-01
期刊：
影响因子：
48
通讯作者：
Bloem, Bastiaan R.
中科院分区：
文献类型：
--
作者：
Nonnekes, Jorik;Snijders, Anke H.;Bloem, Bastiaan R.
步态冻结是帕金森综合征患者常见的致残症状，其特征是突然和短暂的无法产生有效的向前迈步。这些发作通常发生在步态起始或转弯期间。治疗很重要，因为步态冻结是帕金森综合征福尔斯跌倒的主要危险因素，也是患者残疾的来源。存在各种治疗方法，包括药物和手术选择，以及物理治疗和职业治疗，但许多方法的证据是不确定的，没有明确的治疗方案。为了解决这一差距，我们回顾了冻结步态的医疗和非医疗治疗策略，并提出了一个实用的算法来管理这种疾病，根据证据的组合，当可用时，和作者的临床经验。需要进一步的研究来正式确定我们提出的治疗方案的优点。
Freezing of gait is a common and disabling symptom in patients with parkinsonism, characterised by sudden and brief episodes of inability to produce effective forward stepping. These episodes typically occur during gait initiation or turning. Treatment is important because freezing of gait is a major risk factor for falls in parkinsonism, and a source of disability to patients. Various treatment approaches exist, including pharmacological and surgical options, as well as physiotherapy and occupational therapy, but evidence is inconclusive for many approaches, and dear treatment protocols are not available. To address this gap, we review medical and non-medical treatment strategies for freezing of gait and present a practical algorithm for the management of this disorder, based on a combination of evidence, when available, and clinical experience of the authors. Further research is needed to formally establish the merits of our proposed treatment protocol.