关键词: 脑小血管病; 步态障碍; 平衡障碍; 运动功能评价

Abstract:

Objective To explore the kinematic features of gait and balance disorders in patients with cerebral small vessel disease (CSVD). Methods Clinical data were collected in consecutive patients who visited the neurological department in Peking Union Medical College Hospital and were diagnosed with CSVD. Activity of daily living, movement performance, as well as balance and gait disturbance were assessed using several semi-quantitive scales. Results Of the 57 patients included, 71.9% were male, aged 64.5±12.4 years. Twenty six(45.6%) complained of gait disorders but 42(73.7%) were doing well in daily life with Barthel index ≥90. Movement performance in both unified Parkinson’s disease rating scale (UPDRS) and scale for the assessment and rating of ataxia (SARA) were mildly abnormal, with scores of 14.2±10.1 and 5.2±3.6 respectively. Gait dysfunction were found in 40 patients (70.2%, Tinetti-gait score<12), with stride height, stride width, and symmetry of stride length were the most affected gait characteristics. Balance function were affected in 29 patients (50.9%, Tinetti-balance score<16), especially when they were turning 360 degrees, nudged or attempting to arise. Time for walking 3 m in the test of short physical performance battery (SPPB) were 5.0±1.9 seconds, and of 33 patients who took the test battery, 24(72.7%) took more than 3.62 seconds for 3 m walking. Conclusion Gait dysfunction affects more than half of the patients, but these disorders have less impact on both activity of daily living and motor performance than expected. Gait velocity, strideheight, stride width and symmetry of stride length are the most involved gait characteristics, early detection of above disorders can provide chances for preventing falls and delaying disability.

Key words: Cerebral small vessel disease; Gait disorder; Balance dysfunction; Motor function measurement