认知负荷任务对帕金森病患者步态的干扰效应

Interference effects of cognition load task on gait of patients with Parkinson disease

目的:探讨认知负荷任务对帕金森病患者步态的影响。方法:8例帕金森病患者和6例健康对照受试者参与本研究。要求受试者完成以下2种条件下的步行:一是以自己感觉最舒适的速度自由步行2min;二是步行的同时执行一个计算任务。采用三维运动分析仪记录2种条件下的步态参数。此外,要求两组受试者在安静坐位条件下完成2min的计算任务,记录2种条件下的计算完成数和错误率。结果:自由步行条件下,帕金森病组的步幅、步长和步速低于对照组。计算负荷条件下,帕金森病组的步长、步幅、步速、步频、摆动相和单支撑相均显著减低,双支撑相和总支撑相时间显著延长。在加载计算任务后,帕金森病组的步速和步幅变异较其自由步行时显著增加,且步幅变异亦明显高于对照组。帕金森病组安静坐位时计算完成数显著低于对照组,在步行的同时加载计算任务后其计算完成数显著高于对照组。结论:健康老年人的步态对认知调控的依赖程度不高,帕金森病患者的步态明显受认知负荷的干扰,并存在认知资源配置的不合理。

Objective：To explore the effects of cognitive load task on gait in patients with Parkinson disease.Method：Eight patients with Parkinson disease and six control subjects were recruited into this study.All subjects were instructed to walk in two assigned conditions：free walking as usual for 2min and walking as usual for 2min with executing a calculation task.The gait parameters in two conditions were measured with three-dimension motion analysis equipment.All subjects were also instructed to execute a calculation task in sitting condition for 2min.The numbers of completion and error rates in calculation tasks in sitting and walking conditions were recorded.Result：In free walking condition,the stride length,step length and velocity were significantly lower in the patients than those in the controls.In walking with calculation task condition,the step length,stride length,velocity,cadence,swing time and single support time decreased significantly and the double support time and total support time increased significantly in the patients.In the patients,the coefficients of variability in stride length and velocity were significantly higher in walking with calculation task than those in free walking,and the coefficients of variability of stride length increased significantly in comparison with the controls.The numbers of completion of calculation task with sitting were significantly less in the patients than those in the controls.The numbers of completion of calculation task with walking were significantly more in the patients than those in the controls.Conclusion：The gait in the healthy older is seldom modulated by cognitive task.The gait in the patients with Parkinson disease is interfered significantly by cognitive task and there is disharmonious allocation of cognition resource.