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。共有25名帕金森病患者（Hoehn和Yahr期：III-IV期）和16名年龄匹配的健康人参与了这项研究。通过在鞋跟下面放置块来评估鞋跟高度，模拟四种不同鞋跟高度的鞋子；0, 1.0, 1.5, 2.0厘米。与不抬高鞋跟组相比，增高鞋跟组压力中心通路COP通路增加。在年龄匹配的对照组中，COP通路在足跟抬高的情况下也有所增加。与无步态障碍的年龄匹配的对照组相比，帕金森病患者在任何类型的足跟抬高时均表现出较短的COP通路。抬高脚跟对帕金森步态的另一个影响包括加快步伐，缩短两个压力峰值之间的过渡时间。帕金森氏症患者似乎能够以与正常人相似的步态模式行走。足跟抬高对行走测量的影响明显，增加足跟抬高1.0 ~ 2.0cm有助于帕金森病患者的步态改善。这些发现表明，有必要进行进一步的大规模临床试验，以确定改造鞋在帕金森病患者中的临床应用。

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.