不同运动功能障碍对帕金森病患者日常生活活动能力的影响

Influence of specific motor signs to the activities of daily living of patients with Darkinson's disease

目的探讨影响帕金森病(PD)患者日常生活活动(ADL)的运动症状。方法 93例PD患者接受了调查。采用PD统一评分量表第2、3、4部分,分别评估患者的ADL、运动功能障碍和运动并发症。将帕金森病综合评分量表(UPDRS)运动评分分为6部分:震颤、肌强直、动作缓慢、面部表情、语言表达和中轴(步态和姿势)损伤。采用逐步线性回归来评估患者ADL与各具体运动功能障碍之间的相关性。结果中轴损伤是PD患者UPDRS II评分最主要的预测因子,语言表达、动作缓慢和震颤也有一定的预测作用。4项因素相加能够解释72%的UPDRS II评分变化。结论 PD治疗过程中应重视患者的中轴运动损伤症状,加强康复治疗,以提高患者的ADL。

Objective To investigate the contribution of specific motor signs to the activities of daily living （ADL） of idiopathic PD patients. Methods A ＇total of 93 PD patients participated in this study. Ⅱ, Ⅲ, Ⅳ parts of the unified Parkinson ＇s disease rating scale （UPDRS partⅡ,Ⅲ, Ⅳ） were applied to evaluate the ADL, motor impediments, dyskinesias, and clinical fluctuations. The total Unified Parkinson＇s Disease Rating Scale （UPDRS） motor score was divided into 6 motor domains： tremor, rigidity, bradykinesia, facial expression, speech, and axial （gait and postural） impairment. Analyses were performed using linear regression models with the UPDRS Ⅱas the outcome. Results The most important predictive factor was axial impairment, followed by speech, bradykinesia, and tremor, which account for 72% of the variance of outcome. Conclusion Recognition of axial impairment shall become an important part of treatment of PD. Additional rehabilitation treatment may be required to improve the ADL of PD patients.