帕金森病运动学和动力学参数的系统综述，包括步态冻结和不冻结
Systematic review of kinematic and kinetic parameters in Parkinson's disease, with and without freezing of gait.
摘要(中文译文)
帕金森病（PD）是一种慢性、进行性疾病，会损害步态、平衡及整体功能。冻结步态（FOG）是帕金森病一种使人衰弱且普遍存在的症状，表现为尽管有行走意图却无法向前推进。冻结步态中常见僵硬运动和姿势不稳，引发跌倒恐惧，从而影响生活质量。本综述旨在识别在步态相关移动任务中区分伴有和不伴有冻结步态个体的关键生物力学参数。检索于EBSCOhost和SCOPUS数据库进行，截止至2025年5月，以获取测量伴有和不伴有冻结步态个体在步态移动任务中运动学和动力学参数的研究。方法学质量采用改良Downs and Black清单进行评估。总体证据质量采用GRADE系统进行评估。Hedges' g效应量以标准化均数差和95%置信区间报告。共纳入16项研究，涉及513名参与者（259例伴有冻结步态，254例不伴有冻结步态）。结果显示，伴有冻结步态的个体在转身时头部旋转时间延迟，后向行走时髋关节活动范围减小，髋-膝和髋-踝分解指数增加。此外，结果发现伴有冻结步态的个体在行走中存在姿势不稳和机械效率低下。冻结步态不仅仅涉及时空异常，关节活动范围、膝和髋屈曲模式、质心位移及地面反作用力模式等关键生物力学参数可为评估冻结严重程度和监测康复结局提供临床标志物。PROSPERO注册号：CRD42024514366。
Abstract
Parkinson's Disease (PD) is a chronic, progressive disorder, impairing gait, balance and overall functionality. Freezing of gait (FOG) is a debilitating and pervasive symptom of PD, presenting as an inability to make forward progression despite the intention to walk. Commonly seen within FOG are rigid movements and postural instability, inducing a fear of falling which can inhibit quality of life. The aim of this review was to identify the key biomechanical parameters that differentiate individuals with and without FOG during gait-related mobility tasks. A search was conducted in EBSCOhost and SCOPUS up to May 2025 to retrieve studies measuring kinematic and kinetic parameters during gait mobility tasks in individuals with and without FOG. Methodological quality was assessed using a modified Downs and Black checklist. Overall quality of evidence was assessed using the GRADE system. Hedges' g effect sizes were reported as standardised mean differences and 95% confidence intervals. Sixteen studies involving 513 participants (259 with FOG, 254 without FOG) were included. Results showed individuals with FOG produced delayed head rotation timing during turning, decreased hip range of motion and increased hip-knee and hip-ankle decomposition indices during backward walking. Moreover, results found postural instability and mechanical inefficiencies during walking in individuals with FOG. FOG involves more than spatiotemporal irregularities, and key biomechanical parameters such as joint range of motion, knee and hip flexion patterns, centre of mass displacement and ground reaction force patterns can provide clinical markers for assessing freezing severity and monitoring rehabilitation outcomes. PROSPERO registration: CRD42024514366.
如何引用
AMA
Lewis Ball, Fuengfa Khobkhun, Jim Richards, Glen Davison, Jake Bowd. Systematic review of kinematic and kinetic parameters in Parkinson's disease, with and without freezing of gait.. Clinical biomechanics (Bristol, Avon). 2026; doi:10.1016/j.clinbiomech.2026.106853.
APA
Lewis Ball, Fuengfa Khobkhun, Jim Richards, Glen Davison, Jake Bowd (2026). Systematic review of kinematic and kinetic parameters in Parkinson's disease, with and without freezing of gait.. Clinical biomechanics (Bristol, Avon). https://doi.org/10.1016/j.clinbiomech.2026.106853
GB/T 7714
Lewis Ball, Fuengfa Khobkhun, Jim Richards, Glen Davison, Jake Bowd. Systematic review of kinematic and kinetic parameters in Parkinson's disease, with and without freezing of gait.[J]. Clinical biomechanics (Bristol, Avon), 2026 doi:10.1016/j.clinbiomech.2026.106853.
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