ABSTRACT
Background@#and Purpose Orthostatic hypotension (OH) is common in patients with Parkinson’s disease (PD). Early recognition OH is required with sensitive assessments. The purpose of this study was to determine whether blood pressure (BP) changes during exercise can predict the occurrence of OH in PD. @*Methods@#This prospective cohort study included 80 consecutive patients with PD. All patients agreed to participate in a baseline evaluation and cardiopulmonary exercise test (CPET).According to the initial active standing test (AST), those without OH (PD-nonOH) at baseline had their AST results followed up for 6 months. The main outcome was defined as whether patients without OH at baseline would develop OH after 6 months. Logistic regression analysis was applied to identify the relevant variables. A nomogram was constructed based on clinical features and identified variables. The concordance index (C-index) and area under the receiver operating characteristic curve (AUC) were used to evaluate the accuracy and predictive ability of the nomogram, respectively. @*Results@#CPET results indicated that peak load, peak heart rate, heart rate recovery at 1 min, and systolic BP change (ΔSBP) were lower in those with OH than in the PD-nonOH group (p<0.05) at baseline. Logistic regression analysis indicated that peak load and ΔSBP during CPET had significant effects on OH (p<0.05). Age, sex, peak load, and ΔSBP were used to construct the nomogram model (C-index=0.761). The prediction model had an AUC of 0.782 (95% confidence interval=0.649–0.889) and a specificity and sensitivity of 70.0% and 81.8%, respectively. @*Conclusions@#This study has identified predictive factors for OH development in patients with PD. CPET could be used as a complementary examination to identify patients at a high risk of OH.
ABSTRACT
Rehabilitation is increasingly valued in the field of Parkinson's disease (PD) therapy. European countries issued European Physiotherapy Guideline for Parkinson's Disease in 2014. Based on the analysis of the evaluation method in the guideline, combined with the recent literature and clinical feasibility, this paper mainly analyzed the evaluation tools recommended by the European guidelines for physical therapy of PD, the general requirements for using the recommended evaluation tools and the significance of evaluation, in terms of pre-evaluation tools, evaluation tools to assess the effectiveness of physical therapy, evaluation tools to assess the severity and progression of PD and the evaluation of cognitive psychology.
ABSTRACT
Objective:To observe the characteristics of plantar pressure and walking cycle in hemiplegic patients with cerebral infarction. Methods:From April, 2017 to November, 2018, 24 hemiplegic patients with cerebral infarction were analyzed the gait with FDM-T Gait Analysis System. The walking cycle, plantar pressure distribution and plantar spatial-temporal parameters were compared between the paralyzed side and the non-paralyzed side. Results:Compared with the non-paralyzed side, the standing phase decreased in the paralyzed side (t = -3.343, P < 0.01), as well as the middle stage of standing (t = -3.241, P < 0.01); while the walking phase increased (t = 3.342, P < 0.01), the maximum pressure of the middle foot (t = -2.513, P < 0.05) and the maximum strength time of the middle foot (t = -2.631, P < 0.05) decreased, and foot angle increased (t = 3.072, P < 0.01). Conclusion:Standing weight bearing and standing balance training on paralyzed side to extense standing phase, knee joint control training in the middle stage of standing, and correction of metatarsal flexion, pronation and foot deviation, are beneficial to improve walking ability and gait.