Rhythmic auditory stimulation modulates gait variability in Parkinson's disease
Rhythmic auditory stimulation modulates gait variability in Parkinson's disease
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DOI：
10.1111/j.1460-9568.2007.05810.x
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发表时间：
2007-10-01
影响因子：
3.4
通讯作者：
Giladi, Nir
中科院分区：
文献类型：
--
作者：
Hausdorff, Jeffrey M.;Lowenthal, Justine;Giladi, Nir
帕金森病（PD）患者步行时步幅缩短，步幅间变异性高，这是一项与跌倒风险相关的指标。节律性听觉刺激（RAS）可以改善步幅，但对步幅间变异性（跌倒风险的标志）的影响尚不清楚。RAS对步幅时间变异性，摆动时间变异性和时空措施的影响进行了检查，在100米步行与RAS节拍设置为100和110%的每个主题的通常节奏在29例特发性PD和26名健康的年龄匹配的控制。还评价了残留效应。在正常行走过程中，PD患者的变异性显著高于（差于）对照组（P < 0.01）。对于PD患者，RAS在100%时改善了步态速度、步长和摆动时间（P < 0.02），但对变异性无显著影响。当RAS为110%时，也观察到变异性降低（P < 0.03），这些效应在2分钟和15分钟后持续存在。在对照组中，未观察到RAS的积极作用。例如，RAS使步幅时间变异性增加100%和110%。这些结果表明，RAS使更多的自动运动，并减少步幅到步幅的变异性与PD患者。此外，这些改善不仅仅是速度或步幅变化的副产品。在与RAS一起行走后，似乎还有一种遗留效应，支持PD中控制节律性的网络中运动可塑性的可能性，以及使用RAS作为干预措施以改善流动性和降低跌倒风险的可能性。
Patients with Parkinson's disease (PD) walk with a shortened stride length and high stride-to-stride variability, a measure associated with fall risk. Rhythmic auditory stimulation (RAS) improves stride length but the effects on stride-to-stride variability, a marker of fall risk, are unknown. The effects of RAS on stride time variability, swing time variability and spatial-temporal measures were examined during 100-m walks with the RAS beat set to 100 and 110% of each subject's usual cadence in 29 patients with idiopathic PD and 26 healthy age-matched controls. Carryover effects were also evaluated. During usual walking, variability was significantly higher (worse) in the patients with PD compared with the controls (P < 0.01). For the patients with PD, RAS at 100% improved gait speed, stride length and swing time (P < 0.02) but did not significantly affect variability. With RAS at 110%, reductions in variability were also observed (P < 0.03) and these effects persisted 2 and 15 min later. In the control subjects, the positive effects of RAS were not observed. For example, RAS increased stride time variability at 100 and 110%. These results demonstrate that RAS enables more automatic movement and reduces stride-to-stride variability in patients with PD. Further, these improvements are not simply a by-product of changes in speed or stride length. After walking with RAS, there also appears to be a carryover effect that supports the possibility of motor plasticity in the networks controlling rhythmicity in PD and the potential for using RAS as an intervention to improve mobility and reduce fall risk.