The quality of turning in Parkinson's disease: a compensatory strategy to prevent postural instability?
The quality of turning in Parkinson's disease: a compensatory strategy to prevent postural instability?
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帕金森氏病的转弯质量：预防姿势不稳定的补偿性策略？
DOI：
10.1186/s12984-016-0147-4
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发表时间：
2016-04-19
影响因子：
5.1
通讯作者：
Chiari L
中科院分区：
文献类型：
--
作者：
Mellone S;Mancini M;King LA;Horak FB;Chiari L
行走时转身的能力对于日常生活活动至关重要。与对照组相比，帕金森病 (PD) 患者的翻身速度更慢，需要更多的步骤才能完成翻身，但目前尚不清楚这种改变的策略是病理性的还是补偿性的。我们研究的目的是表征帕金森病受试者与对照组受试者在以不同速度行走时连续一系列转弯时的姿势稳定性动态。我们假设帕金森病患者会减慢转身速度以补偿姿势稳定性受损。运动分析用于比较 12 名处于 ON 状态的 PD 受试者和 19 名对照受试者在一条短而直的路径上连续行走时的步态运动学，该路径由 30 至 180° 之间的 11 次右转和左转组成。我们要求受试者以三种不同的速度执行该路线：首选、更快和更慢。从标记轨迹中提取描述步态时空参数和转向特征的特征。此外，为了量化转弯时的动态稳定性，我们计算了支撑底座的侧边缘与身体质心之间的距离，以及推断的身体质心。与对照组相比，患有 PD 的受试者转弯速度较慢，并且转弯时脚之间的距离没有变宽。与对照组相比，患有帕金森病的受试者倾向于缩短转弯时间，从而导致步行路径较短。与健康组相比，PD 的动态稳定性较小，特别是在 90° 的快速转动角度时。 PD 患者较慢的转弯速度和较大的转弯角度可能反映了一种补偿策略，以防止由于支撑基础狭窄而导致动态姿势不稳定。
The ability to turn while walking is essential for daily living activities. Turning is slower and more steps are required to complete a turn in people with Parkinson’s disease (PD) compared to control subjects but it is unclear whether this altered strategy is pathological or compensatory. The aim of our study is to characterize the dynamics of postural stability during continuous series of turns while walking at various speeds in subjects with PD compared to control subjects. We hypothesize that people with PD slow their turns to compensate for impaired postural stability. Motion analysis was used to compare gait kinematics between 12 subjects with PD in their ON state and 19 control subjects while walking continuously on a route composed of short, straight paths interspersed with eleven right and left turns between 30 and 180°. We asked subjects to perform the route at three different speeds: preferred, faster, and slower. Features describing gait spatio-temporal parameters and turning characteristics were extracted from marker trajectories. In addition, to quantify dynamic stability during turns we calculated the distance between the lateral edge of the base of support and the body center of mass, as well as the extrapolated body center of mass. Subjects with PD had slower turns and did not widen the distance between their feet for turning, compared to control subjects. Subjects with PD tended to cut short their turns compared to control subjects, resulting in a shorter walking path. Dynamic stability was smaller in the PD, compared to the healthy group, particularly for fast turning angles of 90°. The slower turning speeds and larger turning angles in people with PD might reflect a compensatory strategy to prevent dynamic postural instability given their narrow base of support.