Background

Gait deficits in Parkinson disease (PD), including freezing of gait (FOG), can be among the most debilitating symptoms. Rhythmic auditory cueing has been used to alleviate some gait symptoms. However, different cue types, such as externally-generated and self-generated cues, affect gait variability differently. The differential effects of these cue types on people with PD with FOG (PD + FOG), who often have higher gait variability, and those with PD without FOG (PD-FOG) is unknown. Given the relationship of gait variability to fall risk, this is an important area to address.

Research question

This study aims to 1) confirm the association between falls and gait variability measures in PD-FOG, PD + FOG and age-matched Controls; 2) investigate the effects of different cue types on gait variability in PD-FOG and PD + FOG; and 3) determine whether baseline gait characteristics are associated with response to cues.

Methods

This cross-sectional study investigated PD-FOG (n = 24), PD + FOG (n = 20), and Controls (n = 24). Gait trials were collected during use of externally-generated and self-generated cues for all participants. Gait variability measures were the primary outcomes to assess the effects of rhythmic auditory cues.

Results

Logistic regression models showed increased gait variability was associated with falls across groups. Repeated measures ANOVAs showed externally-generated cues increased gait variability, whereas self-generated cues did not, for all groups. Pearson’s correlations showed participants with higher baseline gait variability had greater reduction in gait variability with rhythmic auditory cueing.

Significance

Higher gait variability is associated with falls. This study demonstrates that PD + FOG are capable of using self-generated cues without increasing gait variability measures, thereby stabilizing gait. People with higher baseline gait variability are likely to experience the largest reductions in variability with the addition of external cues.

中文翻译：

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有和没有步态冻结的帕金森病患者对外部和自身产生的线索的反应相似。

背景

帕金森病 (PD) 的步态缺陷，包括步态冻结 (FOG)，可能是最令人虚弱的症状之一。有节奏的听觉提示已被用于缓解一些步态症状。然而，不同的线索类型，例如外部生成的和自身生成的线索，对步态变异性的影响不同。这些提示类型对通常具有较高步态变异性的 PD 患者 (PD + FOG) 和无 FOG 的 PD (PD-FOG) 患者的不同影响尚不清楚。鉴于步态可变性与跌倒风险的关系，这是一个需要解决的重要领域。

研究问题

本研究旨在 1) 确认 PD-FOG、PD + FOG 和年龄匹配对照中跌倒与步态变异性测量之间的关联；2) 研究不同线索类型对 PD-FOG 和 PD + FOG 步态变异性的影响；3) 确定基线步态特征是否与对线索的反应相关。

方法

这项横断面研究调查了 PD-FOG（n = 24）、PD + FOG（n = 20）和对照（n = 24）。在为所有参与者使用外部生成和自我生成的线索期间收集了步态试验。步态变异性测量是评估有节奏的听觉线索影响的主要结果。

结果

Logistic 回归模型显示步态变异性增加与各组跌倒相关。对于所有组，重复测量方差分析显示外部生成的线索增加了步态变异性，而自我生成的线索则没有。Pearson 的相关性表明，基线步态变异性较高的参与者在有节奏的听觉提示下，步态变异性的降低幅度更大。

意义

较高的步态变异性与跌倒有关。这项研究表明，PD + FOG 能够使用自生成的线索，而无需增加步态变异性措施，从而稳定步态。随着外部线索的增加，具有较高基线步态变异性的人可能会经历最大的变异性降低。