H44特定住院患者多学科康复计划对亨廷顿病患者姿势和步态稳定性的影响——一项试点研究

L. Brabcová, J. Roth, O. Ulmanová, J. Rusz, J. Klempír, O. Horáček, M. Kolářová, P. Košková, P. Rolková, H. Božková, L. Szabó, M. Inemanová, K. Lísalová, F. Jančok, E. Růžička, H. Brožová
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引用次数: 0

摘要

背景:亨廷顿舞蹈病(HD)的姿势和步态不稳定是导致跌倒的运动症状的重要组成部分,导致发病率和死亡率。康复(RHB)被认为对姿势和步态稳定治疗有益。我们的目的是评估住院多学科康复计划对HD患者姿势和步态稳定性的短期和长期影响。方法选取13例无严重认知障碍或抑郁的HD患者,根据基于HD患者典型步态和稳定性问题的稳定方案,进行为期3周的特定住院多学科康复计划,重点是姿势和步态稳定性。受试者在基线、RHB完成后以及项目后1个月和3个月进行检查。测试内容包括:步态稳定性检查(动态步态指数;DGI),姿势稳定性检查-稳定性极限,在稳定(PSS)和20%不稳定(PSU)平台上进行测试,并通过统一亨廷顿病评定量表(UHDRS)评估总运动评分。结果术后3个月PSS显著改善,DGI显著改善。PSU和UHDRS总运动评分无明显改善。结论特定的RHB方法可改善早期和中期HD患者的姿势和步态不稳定。PSS测量的姿势不稳定改善持续至少3个月。DGI患者的步态稳定性改善在1个月后并未持续。我们发现PSU没有改善。本研究为HD患者的稳定性训练提供了一个特定的RHB方案。
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H44 The effects of a specific inpatient multidisciplinary rehabilitation program on postural and gait stability in huntington´s disease- a pilot study
Background Postural and gait instability in Huntington’s disease (HD) is an essential part of the motor symptomatology causing falls which contribute to morbidity and mortality. Rehabilitation (RHB) is considered beneficial in postural and gait stability treatment. Aims We aimed to evaluate the short- and long-term effects of an inpatient multidisciplinary rehabilitation program on postural and gait stability in HD. Methods A sample of 13 subjects with HD with no severe cognitive deficit or depression underwent a 3-week specific inpatient multidisciplinary rehabilitation program focused on postural and gait stability according to a steady protocol based on typical gait and stability problems in HD. The subjects were examined at the baseline, after the completion of the RHB, and 1 month and 3 months after the program. The testing included: gait stability examination (Dynamic Gait Index; DGI), posturography examination of postural stability- Limits of Stability, tested on a stable (PSS) and 20% unstable (PSU) platform and the total motor score evaluation by Unified Huntington’s Disease Rating Scale (UHDRS). Results There was a significant 3 months lasting improvement in PSS and a significant improvement in DGI immediately after the RHB. There was no significant improvement in PSU and UHDRS total motor score. Conclusions Specific RHB methods may improve postural and gait instability in patients with early and mid-stage HD. The postural instability improvement measured by PSS persisted for at least 3 months. The gait stability improvement in DGI did not persist after 1 month. We found no improvement in PSU. This study offers a specific RHB protocol for stability training in HD.
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