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Effects of a Multidisciplinary Intervention on Daily-Living Gait Among Older Adults With Parkinson’s Disease

机译:多学科干预对帕金森病的老年人日常生活步态的影响

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Abstract Multidisciplinary interventions can improve gait and balance in patients with Parkinson’s disease (PD). However, it is not yet known if these interventions also positively impact the quality of daily-living walking. We, therefore, examined the effects of a multidisciplinary, intensive out-patient rehabilitation program (MIOR) as delivered by the rehabilitation center of EZRA–LEMARPE organization on gait and balance as measured in the clinic and on every-day walking, as measured during 1-week of continuous measurement. 46 PD patients (age: 70.05±7.71; gender: 31.3% women; disease duration: 8.85±6.27 yrs) were evaluated before and after participating in 8-weeks of physical, occupational, and hydro-therapy, boxing, and dance (3 days/week; 5 hrs/day). After the intervention, clinical measures of balance (MiniBest Test of Balance delta: 1.82±3.30 points, p=0.001), mobility (TUG delta: -1.78±6.15sec; p=0.001), and usual-walking speed (delta 19±16cm/s; p0.5). In exploratory analyses, subjects were categorized as responders (Rs) and non-responders (NRs) based on changes in their daily-living walking gait speed. Rs increased their daily-living gait speed (delta: 10±14cm/s; p0.001); NRs did not. Rs (n=21) also improved their daily-living gait quality measures (e.g. stride regularity, step length, stride time variability). At baseline, disease severity (MDS-UPDRSIII) was lower (p=0.02) in Rs (25.33±11.47), compared to the NRs (34.38±14.27). These results demonstrate that improvements in the clinic do not necessarily transfer to improvements in daily-living gait. Further, in select patients, MIOR can ameliorate daily-living walking quality, potentially reducing the risk of falls and other adverse outcomes associated with impaired mobility.
机译:摘要多学科干预措施可以改善帕金森病(PD)患者的步态和平衡。然而,如果这些干预措施也会积极影响日常生活的散步的质量,尚不清楚。因此,我们审查了多学科,密集的出患者康复计划(MIOR)的影响,如EZRA-LEMARPE组织的康复中心在诊所和诊所测量的平衡和每天行走中所测量的恢复中心所提供的影响1周的连续测量。 46例PD患者(年龄:70.05±7.71;性别:31.3%妇女;疾病持续时间:8.85±6.27 YRS在参加8周的物理,职业和水疗治疗,拳击和舞蹈(3天/周; 5小时/天)。干预后,平衡临床措施(衡量平衡δ:1.82±3.30点,P = 0.001),移动性(Tug Delta:-1.78±6.15sec; P = 0.001),常用步行速度(Delta 19± 16cm / s; p0.5)。在探索性分析中,受试者根据日常生活步态速度的变化分类为响应者(RS)和非响应者(NRS)。卢比增加了日常生活的步态速度(三角洲:10±14cm / s; p <0.001); NRS没有。 RS(N = 21)也得到了改善他们的日常活步态质量度量(例如步幅规律性,步长,步时间变异性)。与NRS相比,在基线时,疾病严重程度(MDS-UPDRSIII)为RS(25.33±11.47)中的较低(p = 0.02)(34.38±14.27)。这些结果表明,诊所的改进不一定转移到日常生活步态中的改善。此外,在选择患者中,MIOR可以改善日常生活的行走质量,可能降低落下的风险和与流动性受损相关的不利结果。

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