早期认知障碍患者的认知功能和双重任务步态的临床研究  

Clinic study of cognitive function and dual task gait in patients with early cognitive impairment

作　　者：钟倩 朱奕 吴含 高雅新 孙翠云[3] Nawab Ali 吴希希[4] 王彤 ZHONG Qian;ZHU Yi;WU Han(The First Clinical Medical College of Nanjing Medical University,Nanjing,Jiangsu,210029)

机构地区：[1]南京医科大学第一临床医学院,江苏省南京市210029 [2]南京医科大学第一附属医院康复医学中心 [3]南京大学医学院附属鼓楼医院康复医学科 [4]江苏省人民医院钟山康复分院

出　　处：《中国康复医学杂志》2021年第5期546-552,共7页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金青年科学基金资助项目(81802244);国家自然科学基金面上项目(81772454);国家自然科学基金面上项目(81971237);江苏省科技厅临床前沿技术(BE2017734)。

摘　　要：目的:探索早期认知障碍患者双重任务下步态参数与认知功能之间的关系。方法:本研究共纳入轻度认知障碍者(MCI)20例,主观认知下降者(SCD)34例,认知功能正常者(NC)24例,均采用三维运动捕捉系统及建模仿真分析软件进行单任务及双重任务下步态参数(步长、步速、步频、步态周期)的采集与分析。结果:双重任务下MCI组步频(步/min)(102.173±11.941)小于SCD组步频(110.500±10.435)(P<0.01);MCI组步态周期(s)(1.209±0.133)较NC组步态周期(1.122±0.117)和SCD组步态周期长(1.116±0.102)(P<0.01)。NC组在双重任务下步长(m)及步速(m/s)下降(P<0.01);SCD组在双重任务下步长、步速及步频均下降(P<0.05);MCI组在双重任务下步速、步频及步态周期均下降(P<0.01)。相关性分析显示步速与记忆和语言功能存在正性相关(P=0.005,r=0.312;P=0.014,r=0.277;P=0.005,r=0.317),步频与记忆功能存在正性相关(P=0.010,r=0.289;P=0.012,r=0.283),步态周期与记忆功能存在负性相关(P=0.001,r=﹣0.354),与执行功能存在正性相关(P=0.022,r=0.258)。结论:双重任务下步态参数可作为早期评估认知功能的辅助指标。Objective:To explore the relationship between gait parameters and cognitive function in patients with early cognitive impairment under dual task condition.Method:Twenty patients with mild cognitive impairment,thirty four patients with subjective cognitive decline,and 24 normal cognition elderly were included in this study.Three-dimensional motion capture system and modeling analysis software were used to collect and analyse gait parameters(step length,step speed,cadence and gait cycle).Result:The cadence(steps/min)of the MCI group(102.173±11.941)was lower than that of the SCD group(110.500±10.435)(P<0.01);the stride time(s)of the MCI group(1.209±0.133)was longer than that of the NC group(1.122±0.117)and SCD group(1.116±0.102)(P<0.01).The step length(m)and gait speed(m/s)of the NC group decreased under the dual task condition(P<0.01);the step length,gait speed and cadence of the SCD group decreased under the dual task condition(P<0.05)and the gait speed,cadence and stride time decreased under the dual task condition in MCI group(P<0.01).The correlation analysis showed that there was a positive correlation between gait speed and memory as well as language function(P=0.005,r=0.312;P=0.014,r=0.277;P=0.005,r=0.317),a positive correlation between cadence and memory function(P=0.010,r=0.289;P=0.012,r=0.283),a negative correlation between gait cycle and memory and a positive correlation between executive function(P=0.001,r=﹣0.354;P=0.022,r=0.258).Conclusion:Gait parameters under dual task condition in patients with early cognitive impairment can be used as an early auxiliary index of cognitive function.

关 键 词：轻度认知障碍 主观认知下降 双重任务 步态分析 

分 类 号：R493[医药卫生—康复医学] R318.0[医药卫生—临床医学]