帕金森病患者步行测试的效度研究

The validity of walking tests in people with parkinson’s disease

目的检验帕金森病患者步行测试的同时效度和已知组效度。方法51名帕金森病患者参与研究。采用简明平衡评价系统测试量表(Mini-BEST)、特定活动平衡信心量表(ABC)和蒙特利尔认知功能评估量表分别评估患者平衡功能、平衡效能和认知功能,并记录患者过去12个月中有无跌倒发生。步行测试方案为患者先分别单独完成两个步行任务[即单一任务状态,10米步行测试和起立行走计时(TUG)测试],再在完成步行任务的过程中,执行一项认知任务(即双重任务状态),记录步行时间和正确应答的个数。结果在单一和双重任务状态下,10米步行时间和TUG时间与Mini-BEST和ABC评分均呈中等强度负相关。并且,双重任务状态下的步行时间与ABC评分的相关性略强于单一任务状态下的。然而,步行测试并不能显著区分跌倒者和非跌倒者。结论帕金森患者的步行时间与平衡功能和平衡效能显著相关,且在双重任务状态下相关性更强。然而,其在预测跌倒方面的有用性还需进一步探索。

Objective To assess the concurrent and known-groups validity of walking tests in people with Parkinson’s disease.Methods 51 individuals with Parkinson disease participated in the study.The Mini-balance evaluation system test(Mini-BEST),activity specific balance confidence scale(ABC)and Montreal Cognitive Assessment(MoCA)were used to evaluate the patients’balance function,balance efficacy and cognitive function respectively,and the incidence of falls in the past 12 months was recorded.The walking tests involve performing one of the two walking tasks[i.e.,single-task condition,10 meter walking test and timed up-and-go(TUG)test]first,then simultaneously with one of the two cognitive tasks(i.e.,dual-task condition,mental tracking:serial 3 subtraction;verbal fluency:naming).The walking time and the number of correct responses were recorded.Results Under single and dual task conditions,10-meter walking time and TUG time were negatively correlated with Mini BEST and ABC scores in a medium intensity.Furthermore,the correlation between walking time and ABC scores under dual-task condition was slightly stronger than that of single-task condition.However,the walking assessment could not significantly distinguish between fallers and non-fallers.Conclusion The walking time significantly correlates with balance function and balance efficacy in individuals with PD;furthermore,the correlation would be stronger under dual-task condition.However,its usefulness in predicting falls needs to be further explored.