PDF(Pubmed)
Abstract：
BACKGROUND: The impact of focal dystonia on gait has attracted little attention and remains elusive. Considering the importance of both visual and head control in gait, blepharospasm and cervical dystonia should affect gait. Improvement of cervical/eyelid control following botulinum toxin (BTX) injections would translate into gait changes.
OBJECTIVE: To assess gait differences in people with focal dystonia before and after BTX treatment.
METHODS: Ten patients with blepharospasm, 10 patients with cervical dystonia, and 20 healthy age- and gender-matched controls were included. Gait was assessed before and 1-month after BTX injections using Biodex Gait Trainer™ 3. Gait velocity, cadence, step length, step asymmetry, and variability of step length were compared between patients and controls, and between the two time-points using non-parametric statistics.
RESULTS: At baseline, compared to controls, cervical dystonia patients showed reduced gait velocity, step length, and cadence. After BTX injections, while gait velocity and step length were significantly increased and step length variability reduced, gait parameters still differed between patients and controls. In blepharospasm patients, baseline gait velocity and step length were significantly smaller than in controls. After BTX injections, these gait parameters were significantly increased and variability decreased, so that patients no longer differed from controls.
CONCLUSIONS: Gait differences exist between patients with focal dystonia not directly affecting the lower limbs and healthy controls. These gait abnormalities were improved differently by BTX treatment according to the type of dystonia. These disparities suggest different pathophysiological mechanisms and support the need for changes in rehabilitation routines in cervical dystonia.
OBJECTIVE: To assess gait differences in people with focal dystonia before and after BTX treatment.
METHODS: Ten patients with blepharospasm, 10 patients with cervical dystonia, and 20 healthy age- and gender-matched controls were included. Gait was assessed before and 1-month after BTX injections using Biodex Gait Trainer™ 3. Gait velocity, cadence, step length, step asymmetry, and variability of step length were compared between patients and controls, and between the two time-points using non-parametric statistics.
RESULTS: At baseline, compared to controls, cervical dystonia patients showed reduced gait velocity, step length, and cadence. After BTX injections, while gait velocity and step length were significantly increased and step length variability reduced, gait parameters still differed between patients and controls. In blepharospasm patients, baseline gait velocity and step length were significantly smaller than in controls. After BTX injections, these gait parameters were significantly increased and variability decreased, so that patients no longer differed from controls.
CONCLUSIONS: Gait differences exist between patients with focal dystonia not directly affecting the lower limbs and healthy controls. These gait abnormalities were improved differently by BTX treatment according to the type of dystonia. These disparities suggest different pathophysiological mechanisms and support the need for changes in rehabilitation routines in cervical dystonia.
摘要：
背景：局灶性肌张力障碍对步态的影响很少引起注意，并且仍然难以捉摸。考虑到视觉和头部控制在步态中的重要性，眼睑痉挛和宫颈肌张力障碍应影响步态。肉毒杆菌毒素(BTX)注射后宫颈/眼睑控制的改善将转化为步态变化。
目的：评估BTX治疗前后局灶性肌张力障碍患者的步态差异。
方法：10例眼睑痉挛患者，10例宫颈肌张力障碍患者，纳入20名年龄和性别匹配的健康对照.在BTX注射之前和之后1个月使用BiodexGaitTrainer™3评估步态。步态速度,节奏,步长,台阶不对称，并比较了患者和对照组之间步长的变异性，并使用非参数统计在两个时间点之间。
结果：在基线时，与对照组相比，宫颈肌张力障碍患者的步态速度降低，步长,和节奏。注射BTX后,而步态速度和步长显著增加，步长变异性降低，患者和对照组之间的步态参数仍然不同。在眼睑痉挛患者中，基线步态速度和步长明显小于对照组。注射BTX后,这些步态参数显着增加，变异性降低，这样病人和对照组就不再不同了.
结论：不直接影响下肢的局灶性肌张力障碍患者与健康对照组之间存在步态差异。根据肌张力障碍的类型，通过BTX治疗可以不同地改善这些步态异常。这些差异表明不同的病理生理机制，并支持需要改变宫颈肌张力障碍的康复程序。
目的：评估BTX治疗前后局灶性肌张力障碍患者的步态差异。
方法：10例眼睑痉挛患者，10例宫颈肌张力障碍患者，纳入20名年龄和性别匹配的健康对照.在BTX注射之前和之后1个月使用BiodexGaitTrainer™3评估步态。步态速度,节奏,步长,台阶不对称，并比较了患者和对照组之间步长的变异性，并使用非参数统计在两个时间点之间。
结果：在基线时，与对照组相比，宫颈肌张力障碍患者的步态速度降低，步长,和节奏。注射BTX后,而步态速度和步长显著增加，步长变异性降低，患者和对照组之间的步态参数仍然不同。在眼睑痉挛患者中，基线步态速度和步长明显小于对照组。注射BTX后,这些步态参数显着增加，变异性降低，这样病人和对照组就不再不同了.
结论：不直接影响下肢的局灶性肌张力障碍患者与健康对照组之间存在步态差异。根据肌张力障碍的类型，通过BTX治疗可以不同地改善这些步态异常。这些差异表明不同的病理生理机制，并支持需要改变宫颈肌张力障碍的康复程序。
