帕金森病患者睡眠障碍与步态的关系OACSTPCD

Objective Sleep disorders and gait disorders are common in patients with Parkinson disease(PD).This study aims to investigate the characteristics of gait parameters in patients with Parkinson's disease with and without sleep disorders under different walking paradigms,and explore the relationship between sleep quality and gait parameters by using sleep scales and wearable sensors.Methods One hundred and forty patients with primary PD were divided by the Pittsburgh Sleep Quality Index(PSQI)into PD without sleep disorders(PwtSD group,PSQI<7 points)and PD with sleep disorders(PwSD group,PSQI≥7 points).The patients were asked to walk under three different paradigms:single-task(ST)walking,cognitive dual-task(DT)walking,and closing-the-eyes-task(CET)walking.Wearable gait sensors were used to collect gait data,including 20 spatiotemporal parameters of four gait domains:pace(step length,stride length,and gait speed),rhythm(cadence,gait cycle,double support phase,swing phase),pace/rhythm variability(co-efficient of variation),and pace/rhythm asymmetry(asymmetry index).Results The incidence of sleep disorders was 61.43%(86/140).Under the ST and DT walking paradigms,compared with the PwtSD group,the PwSD group showed significant impaired pace and rhythm variability(both P<0.05).Under the CET paradigm,the PwSD group showed im-pairment in pace,but with no significant between-group difference;the PwSD group had significantly decreased pace vari-ability(P<0.05).Spearman correlation analysis revealed that higher PSQI-sleep efficiency scores were significantly asso-ciated with shorter step and stride lengths and lower gait speed(for ST,r=-0.216,-0.218,-0.192;for DT,r=-0.208,-0.219,-0.189;all P<0.05);for walking with the eyes closed,higher PSQI-sleep efficiency scores were significantly as-sociated with higher variabilities in step length,stride length,and gait speed(r=-0.273,-0.296,-0.238,all P<0.01).Conclusion Sleep disorders are associated with pace and pace/rhythm variability,but not associated with pace/rhythm asymmetry.Stride length variability under the CET walking paradigm may be a usable gait parameter indicating sleep dis-orders in patients with PD.