遗忘型轻度认知障碍日常步态特征及变异性研究

Characteristics of gait function and variability in daily life walking among patients with amnestic mild cognitive impairments

目的研究遗忘型轻度认知功能障碍患者日常步态特征及其变异性。方法纳入28例遗忘型轻度认知功能障碍(aMCI)患者及20名认知功能正常对照者。采用内置传感器可穿戴式步态数据采集鞋(简称“步态鞋”)测量,动态采集受试者的步态数据,每天至少采集1 h,连续2周。采集步态参数包括步行频率、步行速度、跨步长度和跨步时间,以及跨步长度和跨步时间的变异率等。结果aMCI组的步行速度〔(0.97±0.11)m/s比(1.15±0.06)m/s〕、跨步长度〔(0.97±0.11)m比(1.19±0.06)m〕均低于正常对照组(均P<0.05),aMCI组的跨步时间变异率〔(4.04±0.92)%比(3.12±0.92)%〕均高于正常对照组(均P<0.05)。两组间的步态鞋穿着步数总计、跨步时间、步行频率以及跨步长度变异率的差异无统计学意义(均P>0.05)。结论aMCI患者可出现步态障碍的特征性改变,表现为步行速度下降、步长缩短和稳定性下降。基于可穿戴式设备检测的日常生活步态异常和特征性改变对于区分aMCI和认知正常人群可能有帮助。

Objective To characterize gait disturbance in patients with amnestic mild cognitive impairment and determine the association between the performance of the gait function,variability and cognition.Methods In this study,we enrolled 28 patients with amnestic mild cognitive impairment(aMCI)and 20 cognitively normal individuals(NC).Using a built-in-sensor-based wearable instrument,we collected the gait data dynamically for at least one hour/day for 2 weeks.The gait parameters included walking velocity,stride length,stride time,cadence,and the variability of stride length and stride time.Results The walking velocity[(0.97±0.11)m/s vs.(1.15±0.06)m/s]and stride length[(0.97±0.11)m vs.(1.19±0.06)m]in the aMCI group were significantly lower than those in the NCs(P<0.05).The stride time variability in the aMCI group[(4.04±0.92)%vs.(3.12±0.92)%]was higher than that in the NCs(P<0.05).The total number of steps,stride time,cadence and stride length variability did not differ between the two groups(P>0.05).Conclusions This study suggested that cognitive impairment-related gait disorders occurred(reduced gaitspeed,stride length,and gait stability)in daily life walking among the aMCI patients.Gait abnormalities and characteristic changes in daily life detected by wearable devices may be helpful in distinguishing aMCI from cognitively normal adults。