摘要： 目的 探讨下肢康复训练对帕金森病患者运动功能和步态的影响。方法 共计纳入2019年1月至2020年12月重庆医科大学附属第一医院收治的57例原发性帕金森病患者，随机接受常规康复治疗（常规康复组，28例）和常规康复治疗基础上下肢康复训练（下肢康复组，29例），分别于训练前后采用统一帕金森病评价量表第三部分（UPDRSⅢ）评估运动功能、IDEEA可穿戴式步态分析系统评估步态（包括步长、步速、步频）。结果 与训练前相比，两组患者训练4周后UPDRSⅢ评分减少（F=108.572，P=0.000），步长增长（F=66.141，P=0.000），步速增快（F=310.127，P=0.000），步频增加（F=377.174，P=0.000）；与常规康复组相比，训练后下肢康复组患者UPDRSⅢ评分减少（F=7.769，P=0.034），步长增长（F=6.342，P=0.044），步速增快（F=4.815，P=0.049），步频增加（F=8.519，P=0.018）。结论 下肢康复训练可以有效改善帕金森病患者运动功能和步态，值得临床推广应用。

关键词: 帕金森病, 下肢, 运动疗法, 运动障碍, 步态失调

Abstract: Objective To investigate the effects of lower extremity rehabilitation training on motor function and gait in patients with Parkinson's disease (PD). Methods A total of 57 patients with primary PD who were admitted to the First Affiliated Hospital of Chongqing Medical University from January 2019 to December 2020 were included, and randomized to receive conventional rehabilitation therapy (conventional rehabilitation group, n=28) and lower extremity rehabilitation training based on conventional rehabilitation therapy (lower extremity rehabilitation group, n=29), respectively. Before and after training, Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) was used to assess motor function, and IDEEA wearable gait analysis system was used to assess gait (including step length, walk velocity and stride frequency). Results Compared with the pre-training period, patients in 2 groups showed a decrease in UPDRS Ⅲ score (F=108.572, P=0.000), an increase in step length (F=66.141, P=0.000), walk velocity (F=310.127, P=0.000) and stride frequency (F=377.174, P=0.000) after 4 weeks of training. Compared with the conventional rehabilitation group, patients in the lower extremity rehabilitation group had a decrease in UPDRS Ⅲ score (F=7.769, P=0.034), an increased in step length (F=6.342, P=0.044), walk velocity (F=4.815, P=0.049) and stride frequency (F=8.519, P=0.018) after training. Conclusions Lower extremity rehabilitation training can effectively improve motor function and gait in patients with PD, and is worthy of clinical promotion and application.

Key words: Parkinson disease, Lower extremity, Exercise therapy, Motor disorders, Gait apraxia