Neurol. pro Praxi, 2003; 1: 21-25

Poruchy chůze a pády ve stáří

prof. MUDr. Petr Kaňovský CSc
Neurologická klinika FN a LF UP Olomouc

Keywords: poruchy chůze, pády, stáří.

Published: December 31, 2003  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Kaňovský P. Poruchy chůze a pády ve stáří. Neurol. praxi. 2003;4(1):21-25.

Poruchy chůze a náhlé, nečekané pády jsou nejčastější příčinou invalidizace staré populace. Pád ve vyšším věku je téměř vždy příčinou fraktury některé z částí skeletu, a následné upoutání na lůžko je potom u seniorů příčinou řady dalších komplikací, z nichž mnohé mohou být fatální. Je prokázáno, že porucha chůze se zhoršuje a frekvence náhlých, nečekaných pádů se zvyšuje se stoupajícím věkem.

Neurologických příčin poruch chůze a pádů ve stáří je celá řada. Jedná se prakticky o všechny neurologické nemoci, které postihují buď motorický systém jako takový, nebo které postihující systémy, bez jejichž fungování se normální motorika neobejde. Nejčastěji se mohou objevit poruchy chůze a pády ve stáří jako následek neurodegenerativních onemocnění, cévních onemocnění mozku a míchy, a polyneuropatií. Všechna zmíněná onemocnění jsou charakteristická tím, že jejich incidence se zvyšuje s věkem a významně narůstá po dosažení věku 65 let. Proto při vážnější poruše chůze nebo významnější četnosti pádů, které pacienta ohrožují, je na místě změna charakteru mobility a předpis pojízdného křesla.

Download citation

References

  1. Azizah MG, Lajoie Y, Teasdale N. Step length variability at gait initiation in elderly fallers and non-fallers, and young adults. Gerontology 2003; 49: 21-26. Go to original source... Go to PubMed...
  2. Brown LA, Gage WH, Polych MA, Sleik RJ, Winder TR. Central set influences on gait. Age-dependent effects of postoral threat. Exp Brain Res 2002; 145: 286-296. Go to original source... Go to PubMed...
  3. Cartier L. Falls and gait alterations in elderly. Rev Med Chil 2002; 130: 332-337. Go to PubMed...
  4. Deschamps R, Robert PH, Pillon B, Levy R, Dubois B. The concept of frontotemporal lobar degeneration. Rev Neurol 2002; 158: 799-805.
  5. Dingwell JB, Cavangh PR. Increased variability of continuous overground walking in neuropathic patients is only indirectly related to sensory loss. Gait Posture 2001; 14: 1-10. Go to original source... Go to PubMed...
  6. Fletcher PC, Hirdes JP. Risk factors for falling among community-based seniors using home care services. J Gerontol Biol Sci Med Sci 2002; 57: 504-510. Go to original source... Go to PubMed...
  7. Gardner AW, Montgomery PS. Impaired balance and higher prevalence of falls in subjects with intermitent claudication. J Gerontol Biol Sci Med Sci 2001; 56: 454-458. Go to original source... Go to PubMed...
  8. Gerschlager W, Bencsits G, Pirker W, Bloem BR, Asenbaum S, Prayer D, Zijlmans JC, Hoffmann M, Brucke T. [123I] beta-CIT SPECT distinguishes vascular parkinsonism from Parkinson´s disease. Mov Disord 2002; 17: 518-523. Go to original source... Go to PubMed...
  9. Giacomozzi C, Caselli A, Macellari V, Giurato L, Lardieri L, Uccioli L. Walking strategy in diabetic patients with peripheral neuropathy. Diabetes Care 2002; 25: 1451-1457. Go to original source... Go to PubMed...
  10. Giladi N, Treves TA, Simon ES, Shabtai H, Orlov Y, Kandinov B, Paleacu D, Korczyn AD. Freezing of gait in patiets with advanced Parkinson´s disease. J Neural Transm 2001; 108: 53-61. Go to original source... Go to PubMed...
  11. Giladi N, Shabtai H, Rozenberg E, Shabtai E. Gait festination in Parkinson´s disease. Parkinsonism Relat Disord. 2001; 7: 135-138. Go to original source... Go to PubMed...
  12. Hiltunen LA. Does glucose tolerance affect elderly persons´s balance, gait or muslce strength? Cent Eur J Public Healts 2001; 9: 22-25.
  13. Honeycutt PH, Ramsey P. Factors cntibuting to falls in elderly men living in te community. Geriatr Nurs 2002; 23: 250-255. Go to original source... Go to PubMed...
  14. Kaňovský P, Streitová H, Bareš M, Kuba R, Pospíšilová D. Multisystémová atrofie: nový nosologický koncept. Čes Slov Neurol Neurochir 1996; 59: 3-9.
  15. Kaňovský P, Okáčová L, Rektor I. Alzheimerova choroba. Čes Slov Neurol Neurochir 1996; 59: 63-67.
  16. Kaňovský P. Parkinsonské syndromy. Neurol Prax 2000; 1: 23-28.
  17. Kemoun G, Watelain E, Defebvre L, Guieu JD, Destée A. Postural strategies and falls in elderly and in parkinsonism. Ann Readapt Med Phys 2002; 45: 485-492. Go to original source... Go to PubMed...
  18. Martin M, Shinberg M, Kuchibhatla M, Ray L, Carollo JJ, Schenkman ML. Gait initiation in community-dwelling adults with Parkinson´s disease: comparison with older and younger adults without the disease. Phys Ther 2002; 82: 566-577. Go to original source...
  19. McKeith, I. G. and the Consortium on DLBD International Workshop. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLBD). Neurology, 1996; 47: 1113-1124. Go to original source... Go to PubMed...
  20. Meier MR, Desrosiers J, Borassa P, Blasczyk J. Effect of type II diabetic peripheral neuropathy on gait termination in the elderly. Diabetologia 2001; 44: 585-592. Go to original source... Go to PubMed...
  21. Mori H, Oda M, Komori T, Arai N, Takanashi M, Mizutani T, Hirai S, Mizuno Y. Lewy bodies in progressive supranuclear palsy. Acta Neuropatol 2002; 104: 273-278. Go to original source... Go to PubMed...
  22. Richardson JK. Factors associated with falls in older patients with diffuse polyneuropathy. J Am Geriatr Soc 2002; 50: 1767-1773. Go to original source... Go to PubMed...
  23. Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope. Clin Geriatr Med 2002; 18: 141-158. Go to original source... Go to PubMed...
  24. Runge M. Diagnosis of the risk of accidental falls in the elderly. Ther Umsch 2002; 59: 351-358. Go to original source... Go to PubMed...
  25. Summerfield C, Gmez-Anson B, Tolosa E, Mercader JM, Marti MJ, Pastor P, Junque C. Dementia in Parkinson´s disease: a proton magnetic resonance spectroscopy study. Arch Neurol 2002; 59: 1415-1420. Go to original source... Go to PubMed...
  26. Wilson RS, Schneider JA, Beckett LA, Evans DA, Bennett DA. Progression of gait disorder and rigidity and risk of death in older persons. Neurology 2002; 58: 1815-1819. Go to original source... Go to PubMed...
  27. Thomas PK. Classification, differential diagnosis and staging of diabetic peripheral neuropathy. Diabetes 1997; 46 (suppl. 2): 54-57. Go to original source... Go to PubMed...
  28. Verghese J, Litpon RB, Hall CB, Kuslansky G, Katz MJ, Buschke H. Abnormality of gait as a predictor of non-Alzheimer´s dementia. N Engl J Med 2002; 2, 347: 1761-1768. Go to original source... Go to PubMed...
  29. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of and emerging area of research. Gait Posture 2002; 16: 1-14. Go to original source... Go to PubMed...




Neurology for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.