Arm swing magnitude and asymmetry during gait in the early stages of Parkinson's disease.
Arm swing magnitude and asymmetry during gait in the early stages of Parkinson's disease.
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DOI：
10.1016/j.gaitpost.2009.10.013
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发表时间：
2010-02
期刊：
影响因子：
2.4
通讯作者：
Huang, Xuemei
中科院分区：
文献类型：
--
作者：
Lewek, Michael D.;Poole, Roxanne;Johnson, Julia;Halawa, Omar;Huang, Xuemei
帕金森氏病（PD）的晚期特征是步态模式改变。虽然步态中手臂摆动减少是PD患者最常报告的运动功能障碍，但早期PD步态的定量描述在很大程度上忽略了上肢运动。本研究旨在对手臂摆动幅度和不对称性进行定量分析，这可能有助于早期PD的评估。12个人与早期PD（在“关闭”状态）和8个控制进行步态分析，使用基于光学的运动捕捉系统。参与者被指示以正常和快速的速度行走，然后穿高跟鞋（以尽量减少蹬离）。手臂摆动被测量为手腕相对于骨盆的偏移。比较两组之间每只手臂的手臂摆动幅度和臂间不对称性。两组的步态速度相当（p=0.61），在所有行走条件下，两组手臂摆动幅度无显著差异，摆动幅度较大（p=0.907）或较小（p=0.080）。值得注意的是，与对照组（不对称角：5.1±4.0%; p=0.003）相比，PD组显示出显著更大的手臂摆动不对称（不对称角：13.9±7.9%）。与手臂摆动幅度不同，手臂摆动不对称性在早期PD患者和对照组之间存在明显差异。这种手臂摆动的定量评估，特别是其不对称性，可能对早期诊断和鉴别诊断以及跟踪晚期PD患者的疾病进展具有实用价值。
The later stages of Parkinson's disease (PD) are characterized by altered gait patterns. Although decreased arm swing during gait is the most frequently reported motor dysfunction in individuals with PD, quantitative descriptions of gait in early PD have largely ignored upper extremity movements. This study was designed to perform a quantitative analysis of arm swing magnitude and asymmetry that might be useful in the assessment of early PD. Twelve individuals with early PD (in “off” state) and eight controls underwent gait analysis using an optically-based motion capture system. Participants were instructed to walk at normal and fast velocities, and then on heels (to minimize push-off). Arm swing was measured as the excursion of the wrist with respect to the pelvis. Arm swing magnitude for each arm, and inter-arm asymmetry, were compared between groups. Both groups had comparable gait velocities (p=0.61), and there was no significant difference between the groups in the magnitude of arm swing in all walking conditions for the arm that swung more (p=0.907) or less (p=0.080). Strikingly, the PD group showed significantly greater arm swing asymmetry (asymmetry angle: 13.9±7.9%) compared to the control group (asymmetry angle: 5.1±4.0%; p=0.003). Unlike arm swing magnitude, arm swing asymmetry unequivocally differs between people with early PD and controls. Such quantitative evaluation of arm swing, especially its asymmetry, may have utility for early and differential diagnosis, and for tracking disease progression in patients with later PD.
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