Analysis of Dynamics of Gait in Parkinson's Disease with 3-Demensional Gait Analysis System

BACKGROUND: Gait disturbance is one of the most disabling symptoms of Parkinson's disease (PD). To better understand of the dynamics of gait in PD, we quantitatively evaluated the spatiotemporal and kinematic parameters of gait in PD patients and normal controls with 3-demensional gait analysis system. METHODS: The diagnosis of PD was based on UK Brain Bank criteria. Subjects with PD were recruited from Parkinson disease clinic of Korea University Medical Center. The severity was indicated by Hoehn and Yahr stage and Unified Parkinson disease rating scale (UPDRS). The gait analysis and assessment was performed in the off condition. RESULTS: Thirty PD patients and thirty normal controls were included. The statistical significant results of gait analysis between PD and control groups were as followings; reduced walking velocity, reduced stride length, increased double supporting time, reduced pelvic oblique movement with preserved pelvic tilting, reduced maximal flexion and extension of hip joint, reduced flexion angle of knee joint especially in terminal stance phase and swing phase, and reduced plantar flexion of ankle. But there were no significant difference between PD and control groups in cadence. And these parameters except cadence had significant correlation with clinical disability in PD patients. The cadence did not correlated significantly with clinical disability. CONCLUSIONS: The PD patients showed statistically gait cycle change with preserved cadence, reduced range of motion in hip, knee, and ankle joint with preserved ankle dorsiflexion in the profiles. These features were aggravated in advanced stage.

A Case of Severe Obesity-Hypoventilation Syndrome Treated by Bilevel Positive Airway Pressure Therapy

Obesity-Hypoventilation syndrome (OHS) is characterized by morbid obesity, hypoxia, and hypercapnea during wakefulness without parechymal lung disease or severe obstructive sleep apnea. A woman was admitted because of mental deterioration and diagnosed as OHS on the basis of obesity and hypoventilation, while awake, after ruling out other causes. By bilevel positive airway pressure (BiPAP) therapy, hypercapnea and hypoxia were resolved. We report that BiPAP can be an effective treatment for severe hypercapnea and hypoxia in OHS, which obviate the need for invasive endotracheal intubation.