作者：孟茜，刘凤春，王红星，周涌涛，李顷润，常红

单位：

1.100069北京市，首都医科大学护理学院 2.100053北京市，首都医科大学宣武医院神经内科 通信作者：常红，E-mail：changhong19791111@126.com

Units：

1.School of Nursing, Capital Medical University, Beijing 100069, China 2.Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China Corresponding author: CHANG Hong, E-mail: changhong19791111@126.com

关键词：

帕金森病; 冻结步态; 彩色视觉; 绿光视觉干预; 听觉干预;

Keywords：

Parkinson's disease; Freezing of gait; Color vision; Green visual intervention; Auditory intervention

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.180

Funds：

摘要：

目的 探讨绿光视觉干预与听觉干预对帕金森病冻结步态(FOG)的影响。方法 收集2019年4—9月首都医科大学宣武医院收治的帕金森病FOG患者25例为对照组,2019年10月至2020年8月本院收治的帕金森病FOG患者25例为绿光视觉干预组,2020年9月至2021年3月本院收治的帕金森病FOG患者25例为听觉干预组。对照组患者自入院起给予常规治疗及护理;绿光视觉干预组在对照组的基础上于入院第2天开始给予绿色激光线辅助行走的视觉干预训练;听觉干预组在对照组的基础上于入院第2天开始给予“1,2,1”口号辅助行走的听觉干预训练。三组患者分别于入院时、出院时、出院后1个月、出院后3个月采用ADDEEI便携式智能化步态分析仪测量步态指标(包括:坐位起立至站位时间、站位至起步时间、转身时间、站位坐下时间、平均步长及步频),采用统一帕金森病评定量表(UPDRS)评价患者帕金森病严重程度,采用39项帕金森病生活质量问卷(PDQ-39)评价患者生活质量。结果干预方法与时间在平均步长及步频上存在交互作用(P<0.05);干预方法在站位至起步时间及转身时间上主效应显著(P<0.05);时间在坐位起立至站位时间、站位至起步时间、转身时间、站位坐下时间、平均步长及步频上主效应显著(P<0.05)。出院时、出院后1个月、出院后3个月绿光视觉干预组站位至起步时间、转身时间短于对照组,平均步长大于对照组,步频快于对照组(P<0.05);出院时、出院后1个月、出院后3个月听觉干预组站位至起步时间短于对照组,步频快于对照组,出院时听觉干预组转身时间短于对照组,出院后1个月听觉干预组平均步长大于对照组(P<0.05)。干预方法与时间在精神、行为和情绪,日常生活活动,运动检查分量表评分上存在交互作用(P<0.05);干预方法在精神、行为和情绪分量表评分上主效应显著(P<0.05);时间在精神、行为和情绪,日常生活活动,运动检查分量表评分上主效应显著(P<0.05)。出院时、出院后1个月、出院后3个月绿光视觉干预组、听觉干预组精神、行为和情绪,运动检查分量表评分低于对照组,出院后3个月绿光视觉干预组、听觉干预组日常生活活动分量表评分低于对照组(P<0.05)。干预方法与时间在PDQ-39评分上存在交互作用(P<0.05);时间在PDQ-39评分上主效应显著(P<0.05)。出院后3个月绿光视觉干预组、听觉干预组PDQ-39评分低于对照组(P<0.05)。结论 绿色视觉干预及听觉干预均对帕金森病FOG患者的步态、帕金森病严重程度及生活质量起到了有效的改善作用,绿色视觉干预方便、便捷,可在临床推广。

Abstract：

【Abstract】 Objective To investigate the effects of green visual intervention and auditory intervention on freezing ofgait (FOG) in Parkinson's disease (PD) . Methods Twenty-five PD patients with FOG admitted to Xuanwu Hospital of CapitalMedical University from April to September 2019 were selected as control group, 25 PD patients with FOG admitted to the samehospital from October 2019 to August 2020 were selected as green vision intervention group, and 25 PD patients with FOGadmitted to the same hospital from September 2020 to March 2021 were selected as auditory intervention group. The patients inthe control group were given routine treatment and nursing care, the patients in the green vision intervention group were givenvisual intervention training of green laser assisted walking on the second day after admission on the basis of control group, thepatients in the auditory intervention group were given the auditory intervention training of "1, 2, 1" slogan assisted walking on thesecond day after admission on the basis of control group. The gait indexes (including sitting to standing time, standing to startingtime, turning time, sitting down time, average step length and step frequency) were measured by ADDEEI portable intelligent gaitanalyzer, the severity of PD was assessed by the Unified Parkinson's Disease Rating Scale (UPDRS) , and the quality of life wasassessed by the Parkinson's Disease Questionnaire-39 (PDQ-39) at admission, discharge, 1 month after discharge and 3 monthsafter discharge among the three groups. Results There was an interaction between intervention method and time on the averagestep length and step frequency (P < 0.05) ; and the main effect of the intervention method was significant on the standing to startingtime and turning time (P < 0.05) , the main effect of the time was significant on the sitting to standing time, standing to startingtime, turning time, sitting down time, average step length and step frequency (P < 0.05) . At discharge, 1 month after discharge and3 months after discharge, the standing to starting time and turning time in the green vision intervention group were shorter thanthose in the control group, the average step length was larger than that in the control group, and the step frequency was faster thanthat in the control group (P < 0.05) . At discharge, 1 month after discharge and 3 months after discharge, the standing to startingtime in the auditory intervention group was shorter than that in the control group, and the step frequency was faster than that inthe control group; at discharge, the turning time in the auditory intervention group was shorter than that in the control group, at1 month after discharge, the average step length in the auditory intervention group was larger than that in the control group (P <0.05) . There was an interaction between intervention method and time on the scores of spirit, behavior and emotion, activities ofdaily living, motor examination subscale (P < 0.05) ; and the main effect of the intervention method was significant on the scoresof spirit, behavior and emotion subscale (P < 0.05) , the main effect of the time was significant on the scores of spirit, behavior andemotion, activities of daily living, and motor examination subscale (P < 0.05) . At discharge, 1 month after discharge and 3 monthsafter discharge, the scores of spirit, behavior and emotion, and motor examination subscale in the green vision intervention groupand auditory intervention group were lower than those in the control group, at 3 months after discharge, the scores of activities ofdaily living subscale in the green vision intervention group and auditory intervention group were lower than those in the controlgroup (P < 0.05) . There was an interaction between intervention method and time on the PDQ-39 score (P < 0.05) ; and the maineffect of the time was significant on the PDQ-39 score (P < 0.05) . At 3 months after discharge, the PDQ-39 score in the greenvision intervention group and auditory intervention group were lower than those in the control group (P < 0.05) . ConclusionBoth green vision intervention and auditory intervention can effectively improve the gait, severity of PD and quality of life of PDpatients with FOG. Green vision intervention is direct and convenient, can be popularized in clinical practice.

ReferenceList：