Common gait assessment methods for neurological diseases / 中华神经科杂志

Gait is a behavioral characteristic of human walking. The formation mechanism of gait is complex and involves multiple organ systems throughout the body, so there are many factors that affect it. Many factors, such as genetics, diseases and accidental injuries, can change a certain link in the walking cycle, leading to changes in gait and abnormal gait. Accurate assessment of abnormal gait can help diagnose the disease, determine the severity of the disease, predict symptom improvement and future functional status, plan appropriate treatment targets, and monitor the effectiveness of interventions. This paper reviews the gait assessment methods commonly used in neurology, including qualitative gait assessment, scale assessment and instrumentalized gait assessment, in order to improve medical staff′s understanding and application ability of common gait assessment methods.

Validity of Functional Gait Assessment in Patients with Parkinson's Disease / 中国康复理论与实践

@#Objective To investigate the construct and concurrent validity of the Functional Gait Assessment (FGA) as the measure for balance and gait during walking in Parkinson's disease patients. Methods From March to December, 2011, 121 patients with Parkinson's disease (mean aged 61.9 years) were evaluated with FGA by one rater, as well as the other scales for balance and gait, such as Berg Balance Scale, Functional Ambulation Category, Timed Up and Go Test, Activities-specific Balance Confidence Scale, Movement Disorders Society revision of the Unified Parkinson's Disease Rating Scale part 3, modified Barthel Index, maximum walking speed and Modified Hoehn and Yahr Scale. Principal Component Analysis was used to determine construct validity. Spearman correlation coefficients between the FGA and other measures were used to determine concurrent validity. Results One common factor was extracted, which cumulatively explained 64.0% of the total variance. The FGA correlated moderately with the other measures (r = 0.57-0.85). Conclusion FGA is good in validity for Parkinson's disease patients.

Gait, posture and cognition in Parkinson's disease / Marcha, postura e cognição na doença de Parkinson

ABSTRACT Gait disorders and postural instability are the leading causes of falls and disability in Parkinson's disease (PD). Cognition plays an important role in postural control and may interfere with gait and posture assessment and treatment. It is important to recognize gait, posture and balance dysfunctions by choosing proper assessment tools for PD. Patients at higher risk of falling must be referred for rehabilitation as early as possible, because antiparkinsonian drugs and surgery do not improve gait and posture in PD.

RESUMO Distúrbios da marcha e perda de controle postural são as causas principais de queda e incapacidade na doença de Parkinson (DP). A alteração cognitiva desempenha um papel importante para a perda do controle postural e aumenta o risco de quedas; ela também interfere no cuidado e tratamento dos distúrbios da marcha. É importante reconhecer os transtornos da marcha, postura e equilíbrio escolhendo instrumentos de avaliação adequados para identificar os pacientes que tem maior risco de quedas e referi-los para reabilitação o mais precocemente possível, porque os medicamentos e a cirurgia não melhoram a marcha, nem a postura de pacientes com DP.

Relationship between Gait Speed and Muscle Strength of Lower Extremities or Physical Functional Tests / 中国康复理论与实践

Objective To explore the relevance between gait speed and muscle strength of lower extremities, or several kinds of physical functional tests. Methods 341 community-dwelling individuals (160 males, 181 females) aged 65-94 years were selected. They were divid-ed into suspected sarcopenia group (n=137) and normal group (n=204) by their gait speed less or more than 0.8 m/s. It was compared be-tween both groups with the basic physical characteristics, strength of iliopsoas, quadriceps, hamstrings and tibialis anterior, and the scores of One Leg Standing Test, Berg Balance Scale, Functional Gait Assessment, Functional Stretch Test and Timed Up and Go Test. Results The subjects were older in the suspected sarcopenia group than in the normal group. The difference of body weight, height were not statistically significant between groups. The strength of the muscles in bilateral lower limbs was not significantly different between both groups (P>0.05), while the gait speed positively correlated with the strength of iliopsoas, quadriceps and hamstrings (r=0.121-0.227, P0.05). Gait speed positively correlated with the scores of One Leg Standing Test, Berg Balance Scale, Functional Gait Assessment, Functional Stretch Test (P<0.05), and negatively correlated with the score of Timed Up and Go Test (r=-0.502, P<0.001). The scores of all the tests were significantly different between 2 groups (P<0.05), except that of Functional Stretch Test (P=0.28). Conclu-sion Sarcopenia diagnosis is not only depended on the strength of muscle of lower extremity, but also their functions.

Gait analysis comparing Parkinson's disease with healthy elderly subjects / Comparação da doença de Parkinson com idosos saudáveis através da análise da marcha

There is a lack of studies comparing the kinematics data of idiopathic Parkinson's disease (IPD) patients with healthy elder (HE) subjects, and when there is such research, it is not correlated to clinical measures. Objective: To compare the spatio-temporal and kinematic parameters of Parkinsonian gait with the HE subjects group and measure the relation between these parameters and clinical instruments. Method: Twelve patients with IPD and fifteen HE subjects were recruited and evaluated for clinical instruments and gait analysis. Results: There were statistically significant differences between HE group and the IPD group, in stride velocity, in stride length (SL), and in the hip joint kinematic data: on initial contact, on maximum extension during terminal contact and on maximum flexion during mid-swing. Regarding the clinical instruments there were significant correlated with in stride velocity and SL. Conclusion: Clinical instruments used did not present proper psychometric parameters to measure the IPD patient's gait, while the 3D system characterized it better.

Poucos estudos comparam os dados cinemáticos de pacientes com doença de Parkinson idiopática (DPI) com indivíduos idosos saudáveis, e quando realizam não correlacionam com medidas clínicas. Objetivo: Comparar os parâmetros espaço-temporais e cinemáticos da marcha na DP com os de idosos saudáveis (IS) e avaliar a relação entre estes parâmetros com os instrumentos clínicos. Método: Doze pacientes com DPI e quinze IS foram recrutados e avaliados por instrumentos clínicos e de análise de marcha. Resultados: Houve diferenças estatísticas significantes entre o grupo de IS e o de DPI na velocidade da marcha e no comprimento do passo (CP), nos dados cinemáticos das articulações do quadril: no contato inicial, na máxima extensão no apoio e na máxima flexão na oscilação. No que diz respeito aos instrumentos clínicos houve significativa correlação com a velocidade da marcha e SL. Conclusão: Os instrumentos clínicos utilizados não apresentaram adequados parâmetros psicométricos para a avaliação da marcha dos indivíduos com DPI, enquanto uma avaliação em 3D caracteriza melhor a marcha destes indivíduos.