老年脑小血管病患者双重任务行走步态特征

Gait characteristics of dual task walking in elderly patients with CSVD

目的分析老年脑小血管病(CSVD)患者双重任务行走(DTW)步态特征。方法选择解放军总医院第七医学中心住院的老年脑白质损害患者46例为CSVD组和正常老年人22例为对照组,用单独行走和DTW测试,计算跨步时间变异系数(CV)、步态不对称性(GA)及时相协调指数(PCI)。结果与单独行走比较,对照组DTW跨步长变短、步速降低,CSVD组DTW跨步时间延长,跨步长变短,步速降低,步频减慢,CV、GA、PCI明显增加(P<0.01)。单独行走时,CSVD组跨步长和步速明显低于对照组,GA和PCI明显高于对照组[(1.11±0.13)m vs(1.19±0.14)m,(1.01±0.16)m/s vs(1.10±0.15)m/s,2.54(1.58,3.55)vs 2.18(0.00,2.53),(4.44±1.40)vs(2.70±0.74),P<0.05,P<0.01]。DTW时,CSVD组跨步长、步速和步频明显低于对照组,跨步时间、CV、GA、PCI明显高于对照组(P<0.05,P<0.01)。DTW时,CSVD组每步时相φ值的离散程度较大。结论老年CSVD患者在DTW时更易出现步态障碍,步态的稳定性、对称性及协调性降低,DTW更能反映其日常生活活动能力。

Objective To analyze the gait characteristics of DTW in elderly patients with CSVD.Methods Forty-six elderly white matter lesion patients admitted to Chinese PIA Geberal Hospital No.7 Medical Center served as a CSVD group and 22 healthy elderly people served as a control group.The single walking and DTW were tested.The gait parameters were recorded during DTW,such as stride time CV,GA,PCI.Results The stride length was significantly shorter and the stride speed was significantly slower in control group than in single walking group during DTW(P<0.01).The stride time was significantly longer,the stride length was significantly shorter,the stride speed was significantly slower,the stride frequency was significantly lower while the stride time CV,GA and PCI were significantly higher in CSVD group than in single walking group(P<0.01).The stride length was significantly shorter and the stride speed was significantly slower in CSVD group than in control group,while the GA and PCI were significantly higher in CSVD group than in control group[1.11±0.13 m vs 1.19±0.14 m,1.01±0.16 m/s vs 1.10±0.15 m/s,2.54(1.58,3.55)vs 2.18(0.00,2.53),4.44±1.40 vs 2.70±0.74,P<0.05,P<0.01].The stride length was significantly shorter,the stride speed was significantly slower and the stride frequency was significantly lower in CSVD group than in control group during DTW while the stride time was significantly longer,the sride time CV,GA,PCI were significantly higher in CSVD group than in control group during DTW(P<0.05,P<0.01).The discrete value andφvalue differed greatly from the ideal value of 180°.Conclusion Gait disorder is easy to occur and gait stablility,gait symmetry,gait coordination are low in elderly CSVD patients during DTW.DTW can show the daily activities of elderly CSVD patients.