Progressive Gait Deficits in Parkinson's Disease: A Wearable-Based Biannual 5-Year Prospective Study
Progressive Gait Deficits in Parkinson's Disease: A Wearable-Based Biannual 5-Year Prospective Study
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DOI：
10.3389/fnagi.2019.00022
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发表时间：
2019-02-13
影响因子：
4.8
通讯作者：
Heinzel, Sebastian
中科院分区：
文献类型：
--
作者：
Hobert, Markus A.;Nussbaum, Susanne;Heinzel, Sebastian
背景：步态变化发生在帕金森病（PD）的所有阶段，可穿戴传感器衍生的步态参数可以量化PD的进展。然而，量化步态参数作为PD进展标志物的关键方面仍然难以捉摸。目的：研究早期和中期PD患者（E-PD, M-PD）与对照组相比，在方便和具有挑战性的步行条件下，腰背部传感器对步态参数的纵向变化。方法：22例E-PD患者（5年）和24例对照患者，每6个月评估一次正常和快节奏参数（步数、时间、速度、变异性），持续5年。使用广义估计方程检验参数轨迹及其与MDS-UPDRS-III的关联。结果：与对照组（0.7%,-12%）相比，E-PD组正常步速步数（E-PD年变化：2.1%，时间*组：p = 0.001）和步速时间变异性（8.5%,p < 0.05）纵向增加。对于快节奏，两组间无显著进展差异。M-PD的纵向变化与对照组没有显著差异。mds - updrs -ll在很大程度上与M-PD的正常心律参数相关。结论：可穿戴设备可以量化E-PD患者通过增加步数和步数时间变化所显示的进行性步态缺陷。在M-PD和快节奏中，步态参数作为PD进展标志物的潜力有限。
Background: Gait changes occur during all Parkinson's disease (PD) stages and wearable sensor-derived gait parameters may quantify PD progression. However, key aspects that may qualify quantitative gait parameters as progression markers in PD remain elusive.Objectives: Longitudinal changes in gait parameters from a lower-back sensor under convenient and challenging walking conditions in early- and mid-stage PD patients (E-PD, M-PD) compared to controls were investigated.Methods: Normal- and fast-pace parameters (step: number, time, velocity, variability) were assessed every 6 months for up to 5 years in 22 E-PD (5 years) and 24 controls. Parameter trajectories and associations with MDS-UPDRS-III were tested using generalized estimating equations.Results: Normal-pace step number (annual change in E-PD: 2.1%, Time*Group: p = 0.001) and step time variability (8.5%, p < 0.05) longitudinally increased in E-PD compared to controls (0.7%, -12%). For fast pace, no significant progression differences between groups were observed. Longitudinal changes in M-PD did not differ significantly from controls. MDS-UPDRS-lll was largely associated with normal-pace parameters in M-PD.Conclusion: Wearables can quantify progressive gait deficits indicated by increasing step number and step time variability in E-PD. In M-PD, and for fast-pace, gait parameters possess limited potential as PD progression markers.