Effect of heel elevation in Parkinsonan gait

采用步态扫描和F扫描研究了鞋跟抬高对帕金森病患者异常步态的影响。这些测量提供了几个步态参数，包括步行速度，步长，步宽，节奏和足底压力分布。共25例帕金森病患者（Hoehn和Yahr分期：III-IV）和16例年龄匹配的健康人参加了这项研究。用放置在脚跟下方的块来评估脚跟抬高，该块模拟四种不同脚跟高度的鞋; 0、1.0、1.5、2.0 cm。与不抬高足跟相比，抬高足跟时压力中心的路径COP路径增加。在年龄匹配的对照组中，COP通路也在足跟抬高的条件下增加。与年龄匹配的无任何步态障碍的对照组相比，帕金森病患者在任何类型的足跟抬高时均显示出较短的COP通路。脚跟抬高对帕金森步态的另一个影响包括加快节奏，缩短两个压力峰之间的过渡时间。帕金森病患者似乎能够通过脚跟抬高以与正常受试者相似的步态模式行走。足跟抬高对步行测量的影响明显，通过额外的1.0-2.0cm足跟抬高有助于改善帕金森病患者的步态。这些研究结果表明，有必要进一步的临床试验与大规模的样本，以建立帕金森氏病患者的鞋修改的临床效用。

The effects of heel elevation of shoes on an abnormal gait of Parkinson's disease patients were investigated by using the Gait Scan and the F Scan. These measurements provided several gait parameters including walking speed, step length, step width, cadence, and distribution of plantar pressure. Twenty-five total patients with Parkinson's disease (Hoehn and Yahr stage : III-IV) and 16 total age-matched health people participated in this study. Heel elevation was evaluated with blocks placed beneath the heel that simulated shoes at four different heel heights ; 0, 1.0, 1.5, 2.0 cm. The pathway of the center of pressure, COP pathway, increased at the conditions with heel elevation compared with that without heel elevation. In the age-matched control group, the COP pathway also increased at the conditions with heel elevation. Compared with the age-matched control subjects without any gait disturbances, the patients with Parkinson's disease showed shorter COP pathway at any types of heel elevation. Another effects of heel elevation on Parkinsonian gait included hastening cadence, and shortening transitional time between the two pressure peaks. Parkinson's disease patients appeared to be able to walk with a gait pattern similar to the normal subjects by heel elevation. The influence of heel elevation was obviously in the measurements of walking, and it contributed to the improvement of gait in the Parkinson's disease patients through additional heel elevation of 1.0-2.0cm. These findings suggest the necessity of a further clinical trial with a large-scale sample to establish clinical utility of shoe modification in the patients with Parkinson's disease.