{"id":29712,"date":"2023-05-06T22:00:17","date_gmt":"2023-05-06T15:00:17","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29712"},"modified":"2023-05-06T22:09:45","modified_gmt":"2023-05-06T15:09:45","slug":"bien-chung-van-dong-o-benh-nhan-parkinsons-giai-doan-3-va-4","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/bien-chung-van-dong-o-benh-nhan-parkinsons-giai-doan-3-va-4\/","title":{"rendered":"Bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng \u1edf b\u1ec7nh nh\u00e2n Parkinsons giai \u0111o\u1ea1n 3 v\u00e0 4 theo Hoehn v\u00e0 Yahr"},"content":{"rendered":"

Bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng<\/strong> c\u1ee7a b\u1ec7nh nh\u00e2n Parkinson giai \u0111o\u1ea1n 3 v\u00e0 4 c\u00f3 th\u1ec3 g\u00e2y ra \u1ea3nh h\u01b0\u1edfng ti\u00eau c\u1ef1c \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n, bao g\u1ed3m s\u1ef1 gi\u1ea3m kh\u1ea3 n\u0103ng di chuy\u1ec3n v\u00e0 kh\u1ea3 n\u0103ng t\u1ef1 ch\u0103m s\u00f3c b\u1ea3n th\u00e2n, t\u0103ng nguy c\u01a1 v\u1ea5p ng\u00e3 v\u00e0 g\u00e2y t\u1ed5n th\u01b0\u01a1ng, c\u0169ng nh\u01b0 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 t\u00e2m l\u00fd nh\u01b0 tr\u1ea7m c\u1ea3m v\u00e0 lo \u00e2u. B\u1ec7nh Parkinson<\/a> l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u1ea7n kinh ti\u1ebfn tri\u1ec3n ch\u1eadm, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1eadn \u0111\u1ed9ng nh\u01b0 run ch\u00e2n tay, c\u1ee9ng c\u01a1 v\u00e0 ch\u1eadm ch\u1ea1p. B\u1ec7nh \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i theo h\u1ec7 th\u1ed1ng Hoehn v\u00e0 Yahr v\u00e0 chia th\u00e0nh b\u1ed1n giai \u0111o\u1ea1n kh\u00e1c nhau, giai \u0111o\u1ea1n 3 v\u00e0 4 l\u00e0 nh\u1eefng giai \u0111o\u1ea1n ti\u1ebfn tri\u1ec3n nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh.<\/p>\n

\"Bi\u1ebfn
Bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng \u1edf b\u1ec7nh nh\u00e2n Parkinsons giai \u0111o\u1ea1n 3 v\u00e0 4 theo Hoehn v\u00e0 Yahr<\/figcaption><\/figure>\n

Ba\u0300i vi\u00ea\u0301t tri\u0301ch ngu\u00f4\u0300n t\u01b0\u0300 H\u00f4\u0323i th\u00e2\u0300n kinh ho\u0323c Vi\u00ea\u0323t Nam<\/em><\/p>\n

Ta\u0301c gia\u0309:<\/b><\/em><\/p>\n

M\u00f3n Th\u1ecb Uy\u00ean H\u1ed3ng1, Tr\u1ea7n Vi\u1ebft L\u1ef1c2, Nguy\u1ec5n Th\u1ecb Minh Nguy\u1ec7t1<\/em>
\nPh\u1ea1m Th\u1ecb Kim Dung1, L\u00ea Th\u1ecb Quy\u00ean1, Tr\u1ea7n V\u0103n Tu\u1ea5n1<\/em>
\nTr\u01b0\u1eddng \u0110HYD Th\u00e1i Nguy\u00ean1<\/em>
\nTr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y H\u00e0 N\u1ed9i2<\/em><\/p>\n

To\u0301m t\u0103\u0301t<\/strong><\/h2>\n

M\u1ee5c ti\u00eau: M\u00f4 t\u1ea3 \u0111\u1eb7c \u0111i\u1ec3m v\u00e0 m\u1ed1i li\u00ean quan gi\u1eefa c\u00e1c bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng v\u1edbi ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng \u1edf b\u1ec7nh nh\u00e2n Parkinsons giai \u0111o\u1ea1n 3 v\u00e0 4 theo Hoehn v\u00e0 Yahr (H&Y).
\nPh\u01b0\u01a1ng ph\u00e1p: Nghi\u00ean c\u1ee9u m\u00f4 t\u1ea3 c\u1eaft ngang.
\nK\u1ebft qu\u1ea3: 99 b\u1ec7nh nh\u00e2n Parkinson (46 nam\/53 n\u1eef, tu\u1ed5i trung b\u00ecnh: 69,19 \u00b1 7,63) giai \u0111o\u1ea1n 3, 4 theo H&Y (69,3% giai \u0111o\u1ea1n 3), \u0111i\u1ec1u tr\u1ecb t\u1ea1i B\u1ec7nh vi\u1ec7n L\u00e3o khoa Trung \u01b0\u01a1ng t\u1eeb 08\/2019 \u0111\u1ebfn 05\/2020. \u0110i\u1ec3m S&E-ADL v\u00e0 PD-SI trung b\u00ecnh c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u t\u01b0\u01a1ng \u1ee9ng l\u00e0 52,63\u00b113,16 v\u00e0 50,64\u00b114,71; \u0110i\u1ec3m trung b\u00ecnh \u201cv\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d, \u201cnh\u1eadn th\u1ee9c\u201d v\u00e0 \u201ckh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3\u201d cao h\u01a1n \u1edf nh\u00f3m c\u00f3 bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng so v\u1edbi nh\u00f3m b\u1ec7nh nh\u00e2n c\u00f2n l\u1ea1i (p<0,05). C\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng \u1edf c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 \u201cth\u1ea5t b\u1ea1i li\u1ec1u\u201d, \u201cc\u1ea1n li\u1ec1u kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d, \u201clo\u1ea1n \u0111\u1ed9ng giai \u0111o\u1ea1n t\u1eaft\u201d, \u201clo\u1ea1n \u0111\u1ed9ng hai pha\u201d v\u00e0 \u201clo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 bu\u1ed5i s\u00e1ng\u201d so v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng tr\u00ean.
\nK\u1ebft lu\u1eadn: Bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n Parkinson, \u0111\u1eb7c bi\u1ec7t l\u00e0 bi\u1ebfn ch\u1ee9ng \u201cth\u1ea5t b\u1ea1i li\u1ec1u\u201d \u201cc\u1ea1n li\u1ec1u kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d, \u201clo\u1ea1n \u0111\u1ed9ng giai \u0111o\u1ea1n t\u1eaft\u201d, \u201clo\u1ea1n \u0111\u1ed9ng hai pha\u201d v\u00e0 \u201clo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 bu\u1ed5i s\u00e1ng\u201d.
\nT\u1eeb kh\u00f3a: Parkinson, bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng, lo\u1ea1n \u0111\u1ed9ng, dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng, ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng.<\/p>\n

1. \u0110\u0102\u0323T V\u00c2\u0301N \u0110\u00ca\u0300<\/h2>\n

Trong c\u00e1c b\u1ec7nh tho\u00e1i h\u00f3a th\u1ea7n kinh trung \u01b0\u01a1ng, Parkinson l\u00e0 b\u1ec7nh th\u01b0\u1eddng g\u1eb7p \u0111\u1ee9ng th\u1ee9 hai sau Alzheimer. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh Parkinson ch\u1ee7 y\u1ebfu nh\u1eb1m c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng v\u1eadn \u0111\u1ed9ng. Tuy nhi\u00ean, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf giai \u0111o\u1ea1n n\u1eb7ng, b\u1ec7nh Parkinson th\u01b0\u1eddng ph\u1ee9c t\u1ea1p b\u1edfi c\u00e1c v\u1ea5n \u0111\u1ec1 kh\u00e1c nh\u01b0 c\u00e1c bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng li\u00ean quan \u0111\u1ebfn \u0111i\u1ec1u tr\u1ecb, t\u00e9 ng\u00e3, tr\u1ea7m c\u1ea3m v\u00e0 sa s\u00fat tr\u00ed tu\u1ec7, nh\u1eefng y\u1ebfu t\u1ed1 n\u00e0y c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng l\u1edbn h\u01a1n nhi\u1ec1u \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. M\u1ed9t c\u00f4ng c\u1ee5 \u0111\u00e1nh gi\u00e1 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng d\u00e0nh ri\u00eang cho b\u1ec7nh nh\u00e2n Parkinson l\u00e0 PDQ-39, \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 \u0111\u1ed9 tin c\u1eady cao, hi\u1ec7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong nhi\u1ec1u th\u1eed nghi\u1ec7m \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb. \u1ede Vi\u1ec7t Nam, ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u n\u00e0o \u0111\u00e1nh gi\u00e1 m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa c\u00e1c bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n m\u1eafc Parkinson trong nh\u1eefng giai \u0111o\u1ea1n n\u00e0y. Do \u0111\u00f3, ch\u00fang t\u00f4i ti\u1ebfn h\u00e0nh nghi\u00ean c\u1ee9u \u0111\u1ec1 t\u00e0i v\u1edbi m\u1ee5c ti\u00eau: M\u00f4 t\u1ea3 \u0111\u1eb7c \u0111i\u1ec3m v\u00e0 m\u1ed1i li\u00ean quan gi\u1eefa c\u00e1c bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng v\u1edbi ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng \u1edf b\u1ec7nh nh\u00e2n Parkinsons giai \u0111o\u1ea1n 3 v\u00e0 4 theo Hoehn v\u00e0 Yahr.<\/p>\n

2. \u0110\u1ed0I T\u01af\u1ee2NG V\u00c0 PH\u01af\u01a0NG PH\u00c1P NGHI\u00caN C\u1ee8U<\/strong><\/h2>\n

2.1. \u0110\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u<\/strong><\/h3>\n

\u2013 G\u1ed3m 99 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n Parkinson trong giai \u0111o\u1ea1n 3 v\u00e0 4 theo Hoehn v\u00e0 Yahr, \u0111i\u1ec1u tr\u1ecb t\u1ea1i Khoa Th\u1ea7n kinh, B\u1ec7nh vi\u1ec7n L\u00e3o khoa Trung \u01b0\u01a1ng t\u1eeb th\u00e1ng 08\/2019 \u0111\u1ebfn th\u00e1ng 05\/2020.
\n* Ti\u00eau chu\u1ea9n ch\u1ecdn \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u:
\n\u2013 B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1ec7nh Parkinson theo ti\u00eau chu\u1ea9n c\u1ee7a Ng\u00e2n h\u00e0ng n\u00e3o h\u1ed9i Parkinson V\u01b0\u01a1ng Qu\u1ed1c Anh (UKPDSBB). C\u00e1c b\u1ec7nh nh\u00e2n trong giai \u0111o\u1ea1n 3 v\u00e0 4 theo Hoehn v\u00e0 Yahr.
\n* Ti\u00eau chu\u1ea9n lo\u1ea1i tr\u1eeb: Lo\u1ea1i kh\u1ecfi nghi\u00ean c\u1ee9u nh\u1eefng b\u1ec7nh nh\u00e2n sau: C\u00f3 b\u1ec7nh t\u00e2m th\u1ea7n k\u00e8m theo; \u0110ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c an th\u1ea7n kinh; Suy gi\u00e1p tr\u1ea1ng; Nghi\u1ec7n ma t\u00fay v\u00e0\/ho\u1eb7c nghi\u1ec7n r\u01b0\u1ee3u; B\u1ecb c\u00e2m, khi\u1ebfm khuy\u1ebft c\u00e1c gi\u00e1c quan (m\u00f9, \u0111i\u1ebfc); B\u1ec7nh nh\u00e2n m\u00f9 ch\u1eef; B\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u1ed3ng \u00fd tham gia nghi\u00ean c\u1ee9u.<\/p>\n

2.2. Ph\u01b0\u01a1ng ph\u00e1p nghi\u00ean c\u1ee9u<\/strong><\/h3>\n

\u2013 Thi\u1ebft k\u1ebf: Nghi\u00ean c\u1ee9u m\u00f4 t\u1ea3 c\u1eaft ngang
\n\u2013 C\u1ee1 m\u1eabu: m\u1eabu thu\u1eadn ti\u1ec7n, l\u1ea5y to\u00e0n b\u1ed9 b\u1ec7nh nh\u00e2n \u0111\u1ee7 ti\u00eau chu\u1ea9n v\u00e0o nghi\u00ean c\u1ee9u.
\n\u2013 C\u00e1c b\u01b0\u1edbc ti\u1ebfn h\u00e0nh: C\u00e1c b\u1ec7nh nh\u00e2n Parkinson \u0111\u01b0\u1ee3c kh\u00e1m b\u1ec7nh v\u00e0 l\u00e0m b\u1ec7nh \u00e1n theo m\u1eabu b\u1ec7nh \u00e1n nghi\u00ean c\u1ee9u th\u1ed1ng nh\u1ea5t, bao g\u1ed3m: kh\u00e1m ki\u1ec3m tra to\u00e0n di\u1ec7n v\u1ec1 n\u1ed9i khoa, th\u1ea7n kinh, t\u00e2m th\u1ea7n, l\u00e0m c\u00e1c x\u00e9t nghi\u00eam c\u1eadn l\u00e2m s\u00e0ng. \u0110i\u1ec3m PDQ-39 sau \u0111\u00f3 \u0111\u01b0\u1ee3c quy \u0111\u1ed5i sang \u0111i\u1ec3m PD-SI. Trong \u0111\u00f3, t\u1ed5ng \u0111i\u1ec3m c\u1ee7a t\u1ea5t c\u1ea3 39 c\u00e2u h\u1ecfi s\u1ebd \u0111\u01b0\u1ee3c quy ra th\u00e0nh \u0111i\u1ec3m PD-SI= t\u1ed5ng c\u00e1c \u0111i\u1ec3m th\u1ee9 nguy\u00ean c\u1ee7a c\u00e1c l\u0129nh v\u1ef1c\/8.5<\/p>\n

2.3. X\u1eed l\u00fd s\u1ed1 li\u1ec7u<\/strong><\/h3>\n

Theo ph\u01b0\u01a1ng ph\u00e1p th\u1ed1ng k\u00ea y h\u1ecdc.<\/p>\n

2.4. \u0110\u1ea1o \u0111\u1ee9c nghi\u00ean c\u1ee9u<\/strong><\/h3>\n

Nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n sau khi c\u00f3 s\u1ef1 ph\u00ea duy\u1ec7t c\u1ee7a H\u1ed9i \u0111\u1ed3ng Khoa h\u1ecdc v\u00e0 \u0110\u1ea1o \u0111\u1ee9c th\u00f4ng qua. K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u gi\u00fap x\u00e1c \u0111\u1ecbnh m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn ng\u00e3 c\u1ee7a b\u1ec7nh nh\u00e2n Parkinson, kh\u00f4ng nh\u1eb1m m\u1ee5c \u0111\u00edch n\u00e0o kh\u00e1c.<\/p>\n

3. K\u1ebeT QU\u1ea2 NGHI\u00caN C\u1ee8U<\/strong><\/h2>\n

3.1. \u0110\u1eb7c \u0111i\u1ec3m v\u1ec1 tu\u1ed5i, gi\u1edbi v\u00e0 giai \u0111o\u1ea1n b\u1ec7nh c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u<\/strong><\/h3>\n

Tu\u1ed5i trung b\u00ecnh c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u kh\u00e1 cao, \u0111a s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ed9 tu\u1ed5i \u226565, chi\u1ebfm 71,7%. T\u1ef7 l\u1ec7 nam\/n\u1eef trong nghi\u00ean c\u1ee9u l\u00e0 kh\u00e1 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nhau. B\u1ec7nh nh\u00e2n \u1edf giai \u0111o\u1ea1n 3 theo H&Y chi\u1ebfm \u0111a s\u1ed1, v\u1edbi 69,7%.<\/p>\n

3.2. Bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng theo PDQ-39 v\u00e0 S&E-ADL c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u<\/strong><\/h3>\n

B\u1ea3ng 3.1. \u0110\u1eb7c \u0111i\u1ec3m v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u theo c\u00e1c thang \u0111i\u1ec3m PDQ-39, S&E-ADL<\/em><\/p>\n\n\n\n\n\n\n\n\n
\u0110\u1eb7c \u0111i\u1ec3m<\/strong><\/td>\n\u00a0\u00b1 SD<\/strong><\/td>\n\u0110\u1eb7c \u0111i\u1ec3m<\/strong><\/td>\n\u00a0\u00b1 SD<\/strong><\/td>\n<\/tr>\n
\u0110i\u1ec3m S&E-ADL<\/td>\n52,63\u00b113,16<\/td>\nT\u00e2m tr\u1ea1ng<\/td>\n50,00\u00b119,83<\/td>\n<\/tr>\n
\u0110i\u1ec3m PD-SI<\/td>\n50,64\u00b114,71<\/td>\nS\u1ef1 k\u1ef3 th\u1ecb<\/td>\n47,10\u00b120,27<\/td>\n<\/tr>\n
Kh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3<\/td>\n47,64\u00b119,71<\/td>\nH\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i<\/td>\n46,72\u00b118,93<\/td>\n<\/tr>\n
V\u1eadn \u0111\u1ed9ng<\/td>\n58,13\u00b120,09<\/td>\nNh\u1eadn th\u1ee9c<\/td>\n48,23\u00b118,73<\/td>\n<\/tr>\n
Ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y<\/td>\n55,13\u00b120,91<\/td>\nGiao ti\u1ebfp<\/td>\n52,19\u00b117,8<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Nh\u1eadn x\u00e9t:<\/em><\/strong>\u00a0\u0110i\u1ec3m S&E-ADL v\u00e0 PD-SI trung b\u00ecnh c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u t\u01b0\u01a1ng \u1ee9ng l\u00e0 52,63 v\u00e0 50,64. Trong \u0111\u00f3: v\u1eadn \u0111\u1ed9ng, c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y, t\u00e2m tr\u1ea1ng v\u00e0 giao ti\u1ebfp l\u00e0 nh\u1eefng kh\u00eda c\u1ea1nh b\u1ecb \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u nh\u1ea5t<\/p>\n

B\u1ea3ng 3.2. Bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng, lo\u1ea1n \u0111\u1ed9ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u theo thang \u0111i\u1ec3m PDQ-39<\/em><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\u0110\u1eb7<\/strong>c<\/strong>\u00a0\u0111<\/strong>i<\/strong>\u1ec3<\/strong>m<\/strong><\/td>\nBi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng<\/strong><\/td>\n<\/tr>\n
V\u1eadn \u0111\u1ed9ng<\/td>\n0,000b<\/sup><\/td>\n<\/tr>\n
Ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y<\/td>\n0,009c<\/sup><\/td>\n<\/tr>\n
T\u00e2m tr\u1ea1ng<\/td>\n0,186c<\/sup><\/td>\n<\/tr>\n
S\u1ef1 k\u1ef3 th\u1ecb<\/td>\n0,110c<\/sup><\/td>\n<\/tr>\n
H\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i<\/td>\n0,640c<\/sup><\/td>\n<\/tr>\n
Nh\u1eadn th\u1ee9c<\/td>\n0,04c<\/sup><\/td>\n<\/tr>\n
Giao ti\u1ebfp<\/td>\n0,261c<\/sup><\/td>\n<\/tr>\n
Kh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3<\/td>\n0,001c<\/sup><\/td>\n<\/tr>\n
PD-SI<\/td>\n0,008b<\/sup><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

b:<\/sup>\u00a0Independent Sample T-Test<\/p>\n

c:\u00a0<\/sup>U test<\/p>\n

Nh\u1eadn x\u00e9t:\u00a0<\/em><\/strong>C\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng c\u00f3 \u0111i\u1ec3m \u201cv\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d, \u201cnh\u1eadn th\u1ee9c\u201d v\u00e0 \u201ckh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3\u201d cao h\u01a1n so v\u1edbi nh\u00f3m kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng. Nh\u00ecn chung, c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng, \u0111i\u1ec3m UPDRS-IV cao c\u00f3 \u0111i\u1ec3m PD-SI trung b\u00ecnh cao h\u01a1n so v\u1edbi nh\u00f3m kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng.<\/p>\n

B\u1ea3ng 3.3. Dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a theo thang \u0111i\u1ec3m PDQ-39 c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u<\/em><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\u0110\u1eb7<\/strong>c<\/strong>\u00a0\u0111<\/strong>i<\/strong>\u1ec3<\/strong>m<\/strong><\/td>\nDao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng<\/strong><\/td>\nC\u1ea1n li\u1ec1u c\u00f3 d\u1ef1 b\u00e1o tr\u01b0\u1edbc<\/strong><\/td>\nC\u1ea1n li\u1ec1u kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc<\/strong><\/td>\nCh\u1eadm kh\u1edfi ph\u00e1t t\u00e1c d\u1ee5ng<\/strong><\/td>\nTh\u1ea5t b\u1ea1i li\u1ec1u<\/strong><\/td>\nB\u1eadt-t\u1eaft<\/strong><\/td>\n<\/tr>\n<\/thead>\n
V\u1eadn \u0111\u1ed9ng<\/td>\n0,000b<\/sup><\/td>\n0,001b<\/sup><\/td>\n0,000b<\/sup><\/td>\n0,001b<\/sup><\/td>\n0,002b<\/sup><\/td>\n0,000b<\/sup><\/td>\n<\/tr>\n
Ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y<\/td>\n0,004<\/td>\n0,112c<\/sup><\/td>\n0,009c<\/sup><\/td>\n0,05c<\/sup><\/td>\n0,017c<\/sup><\/td>\n0,008c<\/sup><\/td>\n<\/tr>\n
T\u00e2m tr\u1ea1ng<\/td>\n0,091<\/td>\n0,615c<\/sup><\/td>\n0,021c<\/sup><\/td>\n0,3c<\/sup><\/td>\n0,201c<\/sup><\/td>\n0,068c<\/sup><\/td>\n<\/tr>\n
S\u1ef1 k\u1ef3 th\u1ecb<\/td>\n0,003<\/td>\n0,232c<\/sup><\/td>\n0,027c<\/sup><\/td>\n0,062c<\/sup><\/td>\n0,14c<\/sup><\/td>\n0,016c<\/sup><\/td>\n<\/tr>\n
H\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i<\/td>\n0,223<\/td>\n0,224c<\/sup><\/td>\n0,716c<\/sup><\/td>\n0,111c<\/sup><\/td>\n0,381c<\/sup><\/td>\n0,100c<\/sup><\/td>\n<\/tr>\n
Nh\u1eadn th\u1ee9c<\/td>\n0,001<\/td>\n0,105c<\/sup><\/td>\n0,005c<\/sup><\/td>\n0,069c<\/sup><\/td>\n0,443c<\/sup><\/td>\n0,017c<\/sup><\/td>\n<\/tr>\n
Giao ti\u1ebfp<\/td>\n0,001<\/td>\n0,064c<\/sup><\/td>\n0,001c<\/sup><\/td>\n0,019c<\/sup><\/td>\n0,074c<\/sup><\/td>\n0,000c<\/sup><\/td>\n<\/tr>\n
Kh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3<\/td>\n0,000c<\/sup><\/td>\n0,058c<\/sup><\/td>\n0,008c<\/sup><\/td>\n0,009c<\/sup><\/td>\n0,506c<\/sup><\/td>\n0,019c<\/sup><\/td>\n<\/tr>\n
PD-SI<\/td>\n0,000b<\/sup><\/td>\n0,012b<\/sup><\/td>\n0,000b<\/sup><\/td>\n0,004b<\/sup><\/td>\n0,039b<\/sup><\/td>\n0,001b<\/sup><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/em><\/strong>Nh\u1eadn x\u00e9t:\u00a0<\/em><\/strong>C\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 \u201cdao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng\u201d c\u0169ng c\u00f3 \u0111i\u1ec3m\u201d v\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d, \u201cs\u1ef1 k\u1ef3 th\u1ecb\u201d, \u201cnh\u1eadn th\u1ee9c\u201d, \u201cgiao ti\u1ebfp\u201d v\u00e0 \u201ckh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3\u201d cao h\u01a1n so v\u1edbi nh\u00f3m kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng n\u00e0y. Khi x\u00e9t d\u01b0\u1edbi nh\u00f3m, hi\u1ec7n t\u01b0\u1ee3ng \u201cch\u1eadm kh\u1edfi ph\u00e1t t\u00e1c d\u1ee5ng\u201d g\u00e2y ra s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m \u201cv\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d, \u201cgiao ti\u1ebfp\u201d v\u00e0 \u201ckh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3. Hi\u1ec7n t\u01b0\u1ee3ng \u201cth\u1ea5t b\u1ea1i li\u1ec1u\u201d ch\u1ec9 g\u00e2y ra s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m \u201cv\u1eadn \u0111\u1ed9ng\u201d v\u00e0 \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d. Trong khi bi\u1ebfn ch\u1ee9ng\u201d c\u1ea1n li\u1ec1u c\u00f3 d\u1ef1 b\u00e1o \u201cch\u1ec9 g\u00e2y ra c\u00e1c kh\u00f3 kh\u0103n v\u1ec1 \u201cv\u1eadn \u0111\u1ed9ng\u201d. Hi\u1ec7n t\u01b0\u1ee3ng \u201cc\u1ea1n li\u1ec1u kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ea7u h\u1ebft c\u00e1c m\u1eb7t c\u1ee7a ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng. Nh\u00ecn chung, c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng c\u00f3 \u0111i\u1ec3m PD-SI trung b\u00ecnh cao h\u01a1n so v\u1edbi nh\u00f3m kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng n\u00e0y.<\/p>\n

B\u1ea3ng 3.4. D\u1ea1ng lo\u1ea1n \u0111\u1ed9ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng theo PDQ-39 c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u<\/em><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\u0110\u1eb7<\/strong>c<\/strong>\u00a0\u0111<\/strong>i<\/strong>\u1ec3<\/strong>m<\/strong><\/td>\nD\u1ea1ng lo\u1ea1n \u0111\u1ed9ng<\/strong><\/td>\np<\/strong><\/td>\n<\/tr>\n
Lo\u1ea1n \u0111\u1ed9ng\u00a0<\/strong>\u0111\u1ec9<\/strong>nh li\u1ec1u<\/strong><\/td>\nLo\u1ea1n \u0111\u1ed9ng giai \u0111o\u1ea1n t\u1eaft<\/strong><\/td>\nLo\u1ea1n \u0111\u1ed9ng hai pha<\/strong><\/td>\n<\/tr>\n
V\u1eadn \u0111\u1ed9ng<\/td>\n55,79\u00b124,22<\/td>\n75,63\u00b113,23<\/td>\n63,64\u00b111,28<\/td>\n0,01d<\/sup><\/td>\n<\/tr>\n
Ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y<\/td>\n52,41\u00b122,79<\/td>\n71,53\u00b115,47<\/td>\n57,95\u00b116,06<\/td>\n0,035d<\/sup><\/td>\n<\/tr>\n
T\u00e2m tr\u1ea1ng<\/td>\n48,46\u00b121,39<\/td>\n56,60\u00b117,98<\/td>\n57,58\u00b115,83<\/td>\n0,258d<\/sup><\/td>\n<\/tr>\n
S\u1ef1 k\u1ef3 th\u1ecb<\/td>\n47,04\u00b121,99<\/td>\n51,04\u00b116,82<\/td>\n55,11\u00b117,10<\/td>\n0,489d<\/sup><\/td>\n<\/tr>\n
H\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i<\/td>\n41,67\u00b118,00<\/td>\n44,44\u00b123,39<\/td>\n52,27\u00b117,48<\/td>\n0,195d<\/sup><\/td>\n<\/tr>\n
Nh\u1eadn th\u1ee9c<\/td>\n47,04\u00b120,02<\/td>\n56,25\u00b117,68<\/td>\n53,98\u00b111,97<\/td>\n0,324d<\/sup><\/td>\n<\/tr>\n
Giao ti\u1ebfp<\/td>\n45,61\u00b119,52<\/td>\n63,89\u00b113,91<\/td>\n59,09\u00b114,75<\/td>\n0,017d<\/sup><\/td>\n<\/tr>\n
Kh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3<\/td>\n51,75\u00b116,57<\/td>\n59,72\u00b112,22<\/td>\n51,14\u00b119,97<\/td>\n0,354d<\/sup><\/td>\n<\/tr>\n
PD-SI<\/td>\n48,72\u00b116,30<\/td>\n59,89\u00b110,81<\/td>\n56,34\u00b110,53<\/td>\n0,052e<\/sup><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

d<\/sup>: Kruskal Wallis Test<\/p>\n

e<\/sup>: One-way Anova Test<\/p>\n

Nh\u1eadn x\u00e9t:<\/em><\/strong>\u00a0Khi x\u00e9t d\u01b0\u1edbi nh\u00f3m, c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 d\u1ea1ng lo\u1ea1n \u0111\u1ed9ng kh\u00e1c nhau c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m \u201cv\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d v\u00e0 \u201cgiao ti\u1ebfp\u201d. \u0110\u1eb7c bi\u1ec7t l\u00e0 lo\u1ea1n \u0111\u1ed9ng giai \u0111o\u1ea1n t\u1eaft v\u00e0 lo\u1ea1n \u0111\u1ed9ng hai pha.<\/p>\n

B\u1ea3ng 3.5. Lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 bu\u1ed5i s\u00e1ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng theo PDQ-39 c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u<\/em><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\u0110\u1eb7<\/strong>c<\/strong>\u00a0\u0111<\/strong>i<\/strong>\u1ec3<\/strong>m<\/strong><\/td>\nLo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 bu\u1ed5i s\u00e1ng<\/strong><\/td>\np<\/strong><\/td>\n<\/tr>\n
C\u00f3<\/strong><\/td>\nKh\u00f4ng<\/strong><\/td>\n<\/tr>\n
V\u1eadn \u0111\u1ed9ng<\/td>\n67,87\u00b113,16<\/td>\n53,04\u00b121,27<\/td>\n0,000b<\/sup><\/td>\n<\/tr>\n
Ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y<\/td>\n62,75\u00b116,95<\/td>\n46,22\u00b120,54<\/td>\n0,006c<\/sup><\/td>\n<\/tr>\n
T\u00e2m tr\u1ea1ng<\/td>\n57,23\u00b116,36<\/td>\n46,22\u00b120,54<\/td>\n0,009c<\/sup><\/td>\n<\/tr>\n
S\u1ef1 k\u1ef3 th\u1ecb<\/td>\n53,68\u00b116,86<\/td>\n43,65\u00b121,15<\/td>\n0,022c<\/sup><\/td>\n<\/tr>\n
H\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i<\/td>\n49,51\u00b119,78<\/td>\n45,26\u00b118,46<\/td>\n0,272c<\/sup><\/td>\n<\/tr>\n
Nh\u1eadn th\u1ee9c<\/td>\n54,78\u00b114,02<\/td>\n44,81\u00b120,03<\/td>\n0,016c<\/sup><\/td>\n<\/tr>\n
Giao ti\u1ebfp<\/td>\n60,78\u00b114,44<\/td>\n47,69\u00b117,83<\/td>\n0,001c<\/sup><\/td>\n<\/tr>\n
Kh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3<\/td>\n54,17\u00b117,91<\/td>\n54,17\u00b117,91<\/td>\n0,013c<\/sup><\/td>\n<\/tr>\n
PD-SI<\/td>\n57,59\u00b110,6<\/td>\n47,00\u00b115,30<\/td>\n0,000b<\/sup><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Nh\u1eadn x\u00e9t:\u00a0<\/em><\/strong>Ngo\u1ea1i tr\u1eeb nhu c\u1ea7u v\u1ec1 \u201ch\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i\u201d, lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 bu\u1ed5i s\u00e1ng l\u1ea1i g\u00e2y ra \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u1ea5t c\u1ea3 c\u00e1c m\u1eb7t trong \u0111\u1eddi s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n Parkinson.<\/p>\n

4. B\u00c0N LU\u1eacN<\/strong><\/h2>\n

Trong nh\u00f3m nghi\u00ean c\u1ee9u, tu\u1ed5i trung b\u00ecnh c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u kh\u00e1 cao, \u0111a s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ed9 tu\u1ed5i \u226565, chi\u1ebfm 71,7%. T\u1ef7 l\u1ec7 nam\/n\u1eef trong nghi\u00ean c\u1ee9u l\u00e0 kh\u00e1 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nhau.<\/p>\n

C\u00f3 63(63,6%) b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng. C\u00f3 53 (53,5%) b\u1ec7nh nh\u00e2n c\u00f3 lo\u1ea1n \u0111\u1ed9ng v\u00e0 52(52,5%) b\u1ec7nh nh\u00e2n c\u00f3 dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng. 32 (32,3%) trong t\u1ed5ng s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 \u201cc\u1ea1n li\u1ec1u kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d, 37 (37,4%) trong t\u1ed5ng s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 d\u1ef1 \u0111o\u00e1n \u0111\u01b0\u1ee3c th\u1eddi gian xu\u1ea5t hi\u1ec7n bi\u1ebfn ch\u1ee9ng n\u00e0y tr\u01b0\u1edbc khi n\u00f3 x\u1ea3y ra. Hi\u1ec7n t\u01b0\u1ee3ng \u201cb\u1eadt-t\u1eaft\u201d c\u0169ng xu\u1ea5t hi\u1ec7n v\u1edbi t\u1ea7n su\u1ea5t kh\u00e1 cao, 24 (24,4%) b\u1ec7nh nh\u00e2n g\u1eb7p bi\u1ebfn ch\u1ee9ng d\u1ea1ng n\u00e0y. Trong s\u1ed1 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng, hi\u1ec7n t\u01b0\u1ee3ng \u201cc\u1ea1n li\u1ec1u c\u00f3 d\u1ef1 b\u00e1o v\u00e0 kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d chi\u1ebfm t\u01b0\u01a1ng \u1ee9ng 71% v\u00e0 61,5%.<\/p>\n

\u0110i\u1ec3m S&E-ADL trung b\u00ecnh c\u1ee7a \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u l\u00e0 52,63\u00b113,16. \u0110i\u1ec3m PDQ-SI trung b\u00ecnh l\u00e0 50,64\u00b114,71. Trong \u0111\u00f3: v\u1eadn \u0111\u1ed9ng, c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y, t\u00e2m tr\u1ea1ng v\u00e0 giao ti\u1ebfp l\u00e0 nh\u1eefng kh\u00eda c\u1ea1nh b\u1ecb \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u nh\u1ea5t.<\/p>\n

\u0110i\u1ec3m PDQ-39 v\u1ec1 t\u1ea5t c\u1ea3 c\u00e1c m\u1eb7t cao h\u01a1n kh\u00e1 nhi\u1ec1u so v\u1edbi nghi\u00ean c\u1ee9u c\u1ee7a Stephane Chapuis1<\/sup>, Renata Guzzo Souza2<\/sup>\u00a0\u0111\u1eb7c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m h\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i (13,5), giao ti\u1ebfp (30,3), nh\u1eadn th\u1ee9c (34,7) v\u00e0 s\u1ef1 k\u1ef3 th\u1ecb. \u0110i\u1ec3m PD-SI trung b\u00ecnh l\u00e0 50,64\u00b114,71, cao h\u01a1n nghi\u00ean c\u1ee9u c\u1ee7a Chapuis v\u1edbi 36,5 \u0111i\u1ec3m. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 gi\u1ea3i th\u00edch do nghi\u00ean c\u1ee9u c\u1ee7a ch\u00fang t\u00f4i l\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u00e3 \u1edf giai \u0111o\u1ea1n 3 v\u00e0 4, trong khi c\u1ee7a hai t\u00e1c gi\u1ea3 tr\u00ean cho c\u00e1c b\u1ec7nh nh\u00e2n \u1edf t\u1ea5t c\u1ea3 c\u00e1c giai \u0111o\u1ea1n v\u00e0o trong nghi\u00ean c\u1ee9u.<\/p>\n

C\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng c\u00f3 \u0111i\u1ec3m PD-SI cao h\u01a1n so v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng n\u00e0y. Chapius c\u0169ng ch\u1ec9 ra r\u1eb1ng, t\u1ea5t c\u1ea3 c\u00e1c d\u1ea1ng dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng \u0111\u1ec1u l\u00e0m ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n t\u1ed3i t\u1ec7 \u0111i, \u0111i\u1ec3m PD-SI c\u0169ng v\u00ec th\u1ebf t\u0103ng l\u00ean. C\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 \u201cdao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng\u201d c\u0169ng c\u00f3 \u0111i\u1ec3m\u201d v\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d, \u201cs\u1ef1 k\u1ef3 th\u1ecb\u201d, \u201cnh\u1eadn th\u1ee9c\u201d, \u201cgiao ti\u1ebfp\u201d v\u00e0 \u201ckh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3\u201d cao h\u01a1n so v\u1edbi nh\u00f3m kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng n\u00e0y. S\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea v\u1edbi p<0,05. Renata Guzzo Souza v\u00e0 c\u00e1c c\u1ed9ng s\u1ef1 c\u1ee7a \u00f4ng nh\u1eadn th\u1ea5y, dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng g\u00e2y ra s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a v\u1ec1 v\u1eadn \u0111\u1ed9ng, ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y, t\u00e2m tr\u1ea1ng, giao ti\u1ebfp v\u00e0 kh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3. \u00d4ng c\u0169ng cho r\u1eb1ng, s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a c\u00e1c dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng c\u00f3 li\u00ean quan \u0111\u1ebfn ti\u1ebfn tri\u1ec3n t\u1ef1 nhi\u00ean c\u1ee7a b\u1ec7nh, \u0111\u1ebfn vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng levodopa trong th\u1eddi gian d\u00e0i v\u00e0 \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng d\u1eabn \u0111\u1ebfn suy gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng, ch\u1ee7 y\u1ebfu li\u00ean quan \u0111\u1ebfn s\u1ef1 v\u1eadn \u0111\u1ed9ng, c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y, c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111au c\u01a1 v\u00e0 tr\u1ea7m c\u1ea3m c\u1ee7a b\u1ec7nh nh\u00e2n. Calne3<\/sup>\u00a0v\u00e0 c\u00e1c c\u1ed9ng s\u1ef1 c\u1ee7a \u00f4ng nh\u1eadn th\u1ea5y r\u1eb1ng, khi so s\u00e1nh c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 v\u00e0 kh\u00f4ng c\u00f3 dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng trong tr\u1ea1ng th\u00e1i t\u1ed3i t\u1ec7 nh\u1ea5t (t\u1eaft), nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng g\u00e2y n\u00ean nh\u1eefng kh\u00f3 kh\u0103n nhi\u1ec1u h\u01a1n \u0111\u00e1ng k\u1ec3 trong b\u1ed1n kh\u00eda c\u1ea1nh: t\u00e2m l\u00fd, x\u00e3 h\u1ed9i, th\u1ec3 ch\u1ea5t v\u00e0 kinh t\u1ebf. Ngay c\u1ea3 \u1edf tr\u1ea1ng th\u00e1i t\u1ed1t nh\u1ea5t c\u1ee7a h\u1ecd (b\u1eadt), nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng c\u0169ng c\u1ea3m th\u1ea5y b\u1ea3n th\u00e2n b\u1ecb \u1ea3nh h\u01b0\u1edfng l\u1edbn h\u01a1n \u0111\u1ebfn h\u1ea1nh ph\u00fac v\u1ec1 m\u1eb7t x\u00e3 h\u1ed9i so v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng n\u00e0y. M\u1ed9t nghi\u00ean c\u1ee9u \u0111\u00e1nh gi\u00e1 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a 260 b\u1ec7nh nh\u00e2n, g\u1ea7n 30% trong s\u1ed1 \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u c\u00f3 dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng. Nghi\u00ean c\u1ee9u s\u1eed d\u1ee5ng c\u00e1c thang \u0111i\u1ec3m 15D, EQ-5D v\u00e0 PDQ-39. Tr\u00ean c\u1ea3 ba thang \u0111i\u1ec3m, ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng k\u00e9m h\u01a1n \u0111\u00e1ng k\u1ec3 (P <0,001) \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng so v\u1edbi nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng c\u00f36<\/sup>.<\/p>\n

Khi x\u00e9t d\u01b0\u1edbi nh\u00f3m, ch\u00fang t\u00f4i nh\u1eadn th\u1ea5y, c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m PD-SI trung b\u00ecnh gi\u1eefa hai nh\u00f3m b\u1ec7nh nh\u00e2n c\u00f3 \u201cch\u1eadm kh\u1edfi ph\u00e1t t\u00e1c d\u1ee5ng\u201d, \u201cth\u1ea5t b\u1ea1i li\u1ec1u\u201d, \u201cb\u1eadt-t\u1eaft\u201d, \u201cc\u1ea1n li\u1ec1u\u201d n\u00f3i chung v\u00e0 \u201cc\u1ea1n li\u1ec1u kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d v\u00e0 \u201cc\u00f3 d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d n\u00f3i ri\u00eang v\u00e0 nh\u00f3m b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng n\u00e0y (p<0,05).<\/p>\n

Hi\u1ec7n t\u01b0\u1ee3ng \u201cch\u1eadm kh\u1edfi ph\u00e1t t\u00e1c d\u1ee5ng\u201d l\u00e0m t\u0103ng \u0111i\u1ec3m \u201cv\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d, \u201cgiao ti\u1ebfp\u201d v\u00e0 \u201ckh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3\u201d. Hi\u1ec7n t\u01b0\u1ee3ng \u201cth\u1ea5t b\u1ea1i li\u1ec1u\u201d ch\u1ec9 g\u00e2y ra s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m \u201cv\u1eadn \u0111\u1ed9ng\u201d v\u00e0 \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d. Trong khi bi\u1ebfn ch\u1ee9ng\u201dc\u1ea1n li\u1ec1u c\u00f3 d\u1ef1 b\u00e1o \u201cch\u1ec9 g\u00e2y ra c\u00e1c kh\u00f3 kh\u0103n v\u1ec1 \u201cv\u1eadn \u0111\u1ed9ng\u201d. C\u00f3 l\u1ebd do c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u00e3 bi\u1ebft tr\u01b0\u1edbc \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c khi n\u00e0o tri\u1ec7u ch\u1ee9ng c\u1ee7a h\u1ecd x\u1ea5u \u0111i, h\u1ecd ch\u1ee7 \u0111\u1ed9ng trong vi\u1ec7c l\u1eadp k\u1ebf ho\u1ea1ch th\u1ef1c hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng \u1edf c\u00e1c th\u1eddi \u0111i\u1ec3m kh\u00e1c nhau trong ng\u00e0y. Do \u0111\u00f3, h\u1ecd kh\u00f4ng g\u1eb7p nhi\u1ec1u kh\u00f3 kh\u0103n trong cu\u1ed9c s\u1ed1ng nh\u01b0 khi g\u1eb7p c\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00e1c.<\/p>\n

Hi\u1ec7n t\u01b0\u1ee3ng \u201cc\u1ea1n li\u1ec1u\u201d n\u00f3i chung, \u201cc\u1ea1n li\u1ec1u kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d n\u00f3i ri\u00eang v\u00e0 \u0111i\u1ec3m UPDRS-IV cao (>5) l\u00e0m t\u0103ng \u0111i\u1ec3m trung b\u00ecnh c\u1ee7a h\u1ea7u h\u1ebft t\u1ea5t c\u1ea3 c\u00e1c m\u1eb7t c\u1ee7a cu\u1ed9c s\u1ed1ng. Chapius c\u0169ng c\u00f3 \u0111\u1ed3ng quan \u0111i\u1ec3m, khi nghi\u00ean c\u1ee9u c\u1ee7a \u00f4ng cho th\u1ea5y, bi\u1ebfn ch\u1ee9ng \u201cc\u1ea1n li\u1ec1u kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d c\u00f3 m\u1ed1i li\u00ean quan l\u1edbn \u0111\u1ebfn t\u1ea5t c\u1ea3 c\u00e1c kh\u00eda c\u1ea1nh cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. Kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng d\u1ef1 b\u00e1o khi n\u00e0o bi\u1ebfn ch\u1ee9ng x\u1ea3y ra, khi\u1ebfn c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y lu\u00f4n \u1edf th\u1ebf b\u1ecb \u0111\u1ed9ng trong c\u00e1c ho\u1ea1t \u0111\u1ed9ng cu\u1ed9c s\u1ed1ng. H\u1ecd c\u0169ng t\u1ef1 ti, thi\u1ebfu t\u1ef1 tin v\u00e0 ph\u1ee5 thu\u1ed9c nhi\u1ec1u v\u00e0o ng\u01b0\u1eddi th\u00e2n h\u01a1n, t\u1eeb \u0111\u00f3 khi\u1ebfn \u0111\u1eddi s\u1ed1ng tinh th\u1ea7n c\u0169ng b\u1ecb \u1ea3nh h\u01b0\u1edfng. Theo Tanner v\u00e0 Aston4<\/sup>, c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng c\u00f3 xu h\u01b0\u1edbng t\u00e1ch ra kh\u1ecfi x\u00e3 h\u1ed9i do s\u1ee3 c\u00e1c bi\u1ebfn ch\u1ee9ng x\u1ea3y \u0111\u1ebfn b\u1ea5t ng\u1edd v\u00e0 c\u1ea7n c\u00f3 s\u1ef1 h\u1ed7 tr\u1ee3 t\u1eeb b\u00ean ngo\u00e0i b\u1ea5t c\u1ee9 l\u00fac n\u00e0o.<\/p>\n

\u0110i\u1ec3m PD-SI trung b\u00ecnh gi\u1eefa hai nh\u00f3m b\u1ec7nh nh\u00e2n \u201cc\u00f3\u201d bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng cao h\u01a1n so v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng n\u00e0y. C\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng n\u00f3i chung, \u0111i\u1ec3m\u201d v\u1eadn \u0111\u1ed9ng\u201d,\u201d ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d,\u201d nh\u1eadn th\u1ee9c\u201d v\u00e0 \u201ckh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3\u201d cao h\u01a1n so v\u1edbi nh\u00f3m kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng. Gi\u1eefa nh\u00f3m c\u00f3 v\u00e0 kh\u00f4ng c\u00f3 lo\u1ea1n \u0111\u1ed9ng, c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a v\u1ec1 h\u1ea7u h\u1ebft c\u00e1c kh\u00eda c\u1ea1nh c\u1ee7a cu\u1ed9c s\u1ed1ng, tr\u1eeb \u201ch\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i\u201d v\u00e0 \u201cgiao ti\u1ebfp\u201d. Trong nghi\u00ean c\u1ee9u c\u1ee7a ch\u00fang t\u00f4i, c\u00e1c b\u1ec7nh nh\u00e2n \u0111a s\u1ed1 \u0111\u00e3 v\u00e0o giai \u0111o\u1ea1n 3 v\u00e0 4 c\u1ee7a b\u1ec7nh, ph\u1ea7n l\u1edbn \u00edt tham gia v\u00e0o c\u00e1c ho\u1ea1t \u0111\u1ed9ng x\u00e3 h\u1ed9i, lo\u1ea1n \u0111\u1ed9ng v\u00f9ng mi\u1ec7ng tuy c\u00f3 \u1edf m\u1ed9t v\u00e0i b\u1ec7nh nh\u00e2n, nh\u01b0ng kh\u00f4ng qu\u00e1 n\u1eb7ng \u0111\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng giao ti\u1ebfp c\u1ee7a h\u1ecd. Nghi\u00ean c\u1ee9u c\u1ee7a Chapius ch\u1ec9 ra, lo\u1ea1n \u0111\u1ed9ng \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u \u0111\u1ebfn v\u1eadn \u0111\u1ed9ng, c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y, c\u1ea3m gi\u00e1c v\u1ec1 s\u1ef1 k\u1ef3 th\u1ecb v\u00e0 giao ti\u1ebfp \u1edf c\u00e1c b\u1ec7nh nh\u00e2n Parkinson.<\/p>\n

Khi x\u00e9t d\u01b0\u1edbi nh\u00f3m, c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 d\u1ea1ng lo\u1ea1n \u0111\u1ed9ng kh\u00e1c nhau c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m \u201cv\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d v\u00e0 \u201cgiao ti\u1ebfp\u201d. C\u00f3 v\u1ebb nh\u01b0 lo\u1ea1n \u0111\u1ed9ng giai \u0111o\u1ea1n t\u1eaft c\u00f3 li\u00ean quan \u0111\u1ebfn c\u00e1c kh\u00eda c\u1ea1nh \u0111\u00e3 n\u00eau tr\u00ean h\u01a1n c\u1ea3. S\u1ef1 c\u00f3 m\u1eb7t \u0111\u1ed3ng th\u1eddi v\u1edbi s\u1ef1 x\u1ea5u \u0111i c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1eadn \u0111\u1ed9ng, k\u1ebft h\u1ee3p v\u1edbi c\u00e1c \u0111\u1ed9ng t\u00e1c t\u1ef1 \u0111\u1ed9ng khi\u1ebfn b\u1ec7nh nh\u00e2n g\u1eb7p kh\u00f3 kh\u0103n trong nhi\u1ec1u m\u1eb7t c\u1ee7a cu\u1ed9c s\u1ed1ng. \u1ea2nh h\u01b0\u1edfng l\u1edbn th\u1ee9 hai l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng lo\u1ea1n \u0111\u1ed9ng hai pha. Lo\u1ea1n \u0111\u1ed9ng \u0111\u1ec9nh li\u1ec1u c\u00f3 v\u1ebb \u00edt g\u00e2y \u1ea3nh h\u01b0\u1edfng h\u01a1n, m\u1eb7c d\u00f9 c\u00f3. C\u00f3 l\u1ebd do so s\u00e1nh v\u1edbi hai d\u1ea1ng lo\u1ea1n \u0111\u1ed9ng tr\u00ean, th\u00ec lo\u1ea1n \u0111\u1ed9ng \u0111\u1ec9nh li\u1ec1u ch\u1ec9 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng lo\u1ea1n \u0111\u1ed9ng, c\u00f2n c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1eadn \u0111\u1ed9ng l\u1ea1i \u0111ang \u1edf tr\u1ea1ng th\u00e1i ki\u1ec3m so\u00e1t t\u1ed1t. Chapius c\u0169ng cho r\u1eb1ng, b\u1ec7nh nh\u00e2n d\u1ec5 dung n\u1ea1p c\u00e1c tri\u1ec7u ch\u1ee9ng lo\u1ea1n \u0111\u1ed9ng \u0111\u1ec9nh li\u1ec1u h\u01a1n so v\u1edbi c\u00e1c d\u1ea1ng kh\u00e1c. Ngo\u1ea1i tr\u1eeb nhu c\u1ea7u v\u1ec1 \u201ch\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i\u201d, lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 bu\u1ed5i s\u00e1ng l\u1ea1i g\u00e2y ra s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ea5t c\u1ea3 c\u00e1c m\u1eb7t trong \u0111\u1eddi s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n Parkinson. Chapius cho r\u1eb1ng lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 bu\u1ed5i s\u00e1ng ch\u1ec9 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y, s\u1ef1 k\u1ef3 th\u1ecb v\u00e0 g\u00e2y ra c\u00e1c kh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3. C\u00f3 l\u1ebd do s\u1ef1 ch\u1ed3ng ch\u00e9o c\u1ee7a c\u00e1c d\u1ea1ng bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng \u0111i k\u00e8m, c\u00f9ng v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1eadn \u0111\u1ed9ng \u1edf giai \u0111o\u1ea1n n\u00e0y kh\u00e1 tr\u1ea7m tr\u1ecdng d\u1eabn \u0111\u1ebfn s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y. Do ph\u1ea7n l\u1edbn c\u00e1c lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 di\u1ec5n ra trong th\u1eddi gian kh\u00e1 ng\u1eafn, \u0111a s\u1ed1 c\u00e1c b\u1ec7nh nh\u00e2n ch\u1ec9 ph\u00e0n n\u00e0n v\u1ec1 tri\u1ec7u ch\u1ee9ng \u0111au do ch\u00fang mang l\u1ea1i. S\u1ef1 lo l\u1eafng v\u1ec1 vi\u1ec7c xu\u1ea5t hi\u1ec7n c\u00e1c lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c g\u00e2y \u0111au n\u00e0y c\u0169ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00e2m tr\u1ea1ng b\u1ec7nh nh\u00e2n, khi \u0111a s\u1ed1 x\u1ea3y ra v\u00e0o th\u1eddi \u0111i\u1ec3m g\u1ea7n s\u00e1ng. S\u1ef1 lo l\u1eafng ph\u1ea3i t\u1ef1 m\u00ecnh xoay x\u1edf v\u1edbi tri\u1ec7u ch\u1ee9ng, k\u00e8m theo s\u1ef1 \u00e1i ng\u1ea1i khi l\u00e0m phi\u1ec1n \u0111\u1ebfn ng\u01b0\u1eddi nh\u00e0 c\u00f3 th\u1ec3 gi\u1ea3i th\u00edch cho s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m t\u00e2m tr\u1ea1ng, \u0111i\u1ec3m s\u1ef1 k\u1ef3 th\u1ecb, giao ti\u1ebfp v\u00e0 kh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3, nh\u01b0ng kh\u00f3 gi\u1ea3i th\u00edch cho s\u1ef1 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c m\u1eb7t c\u00f2n l\u1ea1i. C\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb lo\u1ea1n \u0111\u1ed9ng \u0111\u00e3 l\u00e2u (\u22642 n\u0103m) c\u0169ng c\u00f3 \u0111i\u1ec3m \u201cv\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d, \u201ct\u00e2m tr\u1ea1ng\u201d v\u00e0 \u201cs\u1ef1 k\u1ef3 th\u1ecb\u201d cao h\u01a1n so v\u1edbi nh\u00f3m m\u1edbi b\u1ecb (<2 n\u0103m).<\/p>\n

5. K\u1ebeT LU\u1eacN<\/strong><\/h2>\n

Bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng c\u00f3 m\u1ed1i li\u00ean quan ch\u1eb7t ch\u1ebd v\u1edbi ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n Parkinson. \u0110\u1eb7c bi\u1ec7t dao \u0111\u1ed9ng v\u1eadn \u0111\u1ed9ng d\u1ea1ng \u201cc\u1ea1n li\u1ec1u kh\u00f4ng d\u1ef1 b\u00e1o tr\u01b0\u1edbc\u201d c\u00f3 li\u00ean quan \u0111\u1ebfn h\u1ea7u h\u1ebft c\u00e1c m\u1eb7t c\u1ee7a cu\u1ed9c s\u1ed1ng. Lo\u1ea1n \u0111\u1ed9ng c\u00f3 m\u1ed1i li\u00ean quan \u0111\u1ebfn h\u1ea7u h\u1ebft t\u1ea5t c\u1ea3 c\u00e1c m\u1eb7t c\u1ee7a cu\u1ed9c s\u1ed1ng, \u0111\u1eb7c bi\u1ec7t lo\u1ea1n \u0111\u1ed9ng giai \u0111o\u1ea1n t\u1eaft, lo\u1ea1n \u0111\u1ed9ng hai pha v\u00e0 lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 bu\u1ed5i s\u00e1ng.<\/p>\n

\u1ede c\u00e1c b\u1ec7nh nh\u00e2n Parkinson giai \u0111o\u1ea1n 3 v\u00e0 4, \u201cv\u1eadn \u0111\u1ed9ng\u201d, \u201cho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y\u201d, \u201cs\u1ef1 k\u1ef3 th\u1ecb\u201d, \u201cnh\u1eadn th\u1ee9c\u201d, \u201cgiao ti\u1ebfp\u201d v\u00e0 \u201ckh\u00f3 ch\u1ecbu c\u01a1 th\u1ec3\u201d l\u00e0 c\u00e1c kh\u00eda c\u1ea1nh b\u1ecb \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u nh\u1ea5t.<\/p>\n

T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/strong><\/h2>\n

1. Chapuis S, Ouchchane L, Metz O, Gerbaud L, Durif F. Impact of the motor complications of Parkinson\u2019s disease on the quality of life. Mov Disord. 2005;20(2):224-230. doi:10.1002\/mds.20279.
\n2. Souza RG, Borges V, Silva SMC de A, Ferraz HB. Quality of life scale in Parkinson\u2019s disease PDQ-39 \u2013 (Brazilian Portuguese version) to assess patients with and without levodopa motor fluctuation. Arquivos de Neuro-Psiquiatria. 2007;65(3B):787-791. doi:10.1590\/S0004-282X2007000500010.
\n3. Calne S, Schulzer M, Mak E, et al. Validating a quality of life rating scale for idiopathic Parkinsonism: Parkinson\u2019s Impact Scale (PIMS). Parkinsonism Relat Disord. 1996;2(2):55-61. doi:10.1016\/1353-8020(95)00026-7.
\n4. Tanner CM, Aston DA. Epidemiology of Parkinson\u2019s disease and akinetic syndromes. Curr Opin Neurol. 2000;13(4):427-430. doi:10.1097\/00019052-200008000-00010.
\n5. Parkinson\u2019s Disease Questionnaire \u2013 39. Shirley Ryan AbilityLab. Accessed September 12, 2020. https:\/\/www.sralab.org\/rehabilitation-measures\/Parkinsons-disease-questionnaire-39.
\n6. Schrag A, Jahanshahi M, Quinn N. How does Parkinson\u2019s disease affect quality of life? A comparison with quality of life in the general population. Mov Disord. 2000;15(6):1112-1118.doi:10.1002\/1531-8257(200011)15:6<1112::aid-mds1008>3.0.co;2-a.<\/p>\n","protected":false},"excerpt":{"rendered":"

Bi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng c\u1ee7a b\u1ec7nh nh\u00e2n Parkinson giai \u0111o\u1ea1n 3 v\u00e0 4 c\u00f3 th\u1ec3 g\u00e2y ra \u1ea3nh h\u01b0\u1edfng ti\u00eau c\u1ef1c \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n, bao g\u1ed3m s\u1ef1 gi\u1ea3m kh\u1ea3 n\u0103ng di chuy\u1ec3n v\u00e0 kh\u1ea3 n\u0103ng t\u1ef1 ch\u0103m s\u00f3c b\u1ea3n th\u00e2n, t\u0103ng nguy c\u01a1 v\u1ea5p ng\u00e3 v\u00e0 g\u00e2y t\u1ed5n th\u01b0\u01a1ng, c\u0169ng […]<\/p>\n","protected":false},"author":42,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nBi\u1ebfn ch\u1ee9ng v\u1eadn \u0111\u1ed9ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng \u1edf b\u1ec7nh nh\u00e2n Parkinsons giai \u0111o\u1ea1n 3 v\u00e0 4 theo Hoehn v\u00e0 Yahr<\/title>\n<meta name=\"description\" content=\"Bi\u1ebfn ch\u1ee9ng v\u1eadn 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