血管性轻度认知障碍老年人双重任务行走下步态参数特征与跌倒的关系

Gait Characteristics under Dual-task Condition and Their Relationship with Fall among Old Patients with Vascular Mild Cognitive Impairment

目的探讨血管性轻度认知障碍(VaMCI)老年患者双重任务行走下步态参数特征与跌倒的关系。方法 2019年3月至9月,采用便利抽样法选择符合标准的103例VaMCI老年患者,按照过去1年有无跌倒情况,分为跌倒组(n=45)和未跌倒组(n=58)。对两组进行一般资料调查,采用改良Barthel指数(MBI)、计时起立行走测试(TUGT)进行评定,并采用便携式步态分析仪采集双重任务行走状况下的步态参数。结果未跌倒组MBI显著高于跌倒组(t=35.688, P <0.001),TUGT所用时间短于跌倒组(t=2.428, P <0.05)。未跌倒组步速、步长、步频、摆动相和地面冲击力均大于跌倒组(t> 2.536,|Z|> 1.986, P <0.05),单步时间和站立相小于跌倒组(|Z|> 2.440, P <0.05)。步速、步长、步频、单步时间是跌倒发生的独立危险因素(P <0.05)。结论双重任务下的步态参数特征可反映VaMCI老年患者步行能力,提示跌倒风险。应当重视步速、步长、步频、单步时间相关参数变化并及时采取有效措施评估及干预。

Objective To investigate the relationship between gait parameters under dual-task condition and falls in old patients with vascular mild cognitive impairment(VaMCI).Methods From March to September,2019,convenience sampling method was adopted to select 103 old patients with VaMCI.They were divided into falling group(n=45)and non-falling group(n=58),according to the situation of falling in the past one year.Both groups were surveyed general data,assessed with modified Barthel Index(MBI)and Timed“Up and Go”Test(TUGT),and collected gait parameters under dual-task condition.Results MBI score was significantly higher(t=35.688,P<0.001),and the time of TUGT was shorter(t=2.428,P<0.05)in the non-falling group than in the falling group.The speed,length,frequency,swing phase and ground impact were higher(t>2.536,|Z|>1.986,P<0.05),and single step time and the stance phase were lower(|Z|>2.440,P<0.05)in the non-falling group than in the falling group.Speed,length,frequency and single step time were risk factors for falling(P<0.05).Conclusion The characteristics of gait parameters under dual-task condition could reflect the walking ability of the old patients with VaMCI,suggesting the risk of fall,especially speed,length,frequency and single step time,which need to be measured and intervened in time.