Anticipatory postural adjustments prior to step initiation are hypometric in untreated Parkinson's disease: an accelerometer-based approach
Anticipatory postural adjustments prior to step initiation are hypometric in untreated Parkinson's disease: an accelerometer-based approach
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DOI：
10.1111/j.1468-1331.2009.02641.x
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发表时间：
2009-09-01
影响因子：
5.1
通讯作者：
Horak, F. B.
中科院分区：
文献类型：
--
作者：
Mancini, M.;Zampieri, C.;Horak, F. B.
背景和目的：在步骤开始之前，预期姿势调整（APA）在晚期帕金森病（PD）中是运动迟缓的，并且可能是与“开始犹豫”相关的因素之一。然而，对于PD早期的APA却知之甚少。在这项研究中，我们确定了是否可以使用穿戴式加速度计来表征未经治疗的早期至中度 PD 受试者的迈步缺陷。方法：要求 11 名 PD 受试者和 12 名健康对照受试者迈出两步。从压力中心 (COP) 和重心水平 (L5) 的躯干加速度来比较姿势调整。结果：我们的研究结果表明，与对照组相比，未经治疗的 PD 受试者根据朝向摆动腿的峰值 COP 位移和朝向站立腿的峰值躯干加速度测量的 APA 更小。从峰值 COP 位移和加速度测得的 APA 大小是相关的。 结论：这些结果表明，对躯干上的一个加速计的迈步启动进行定量分析可以为 PD 早期阶段患者的特征提供有用的信息，此时可能无法检测到开始犹豫的临床证据。步态启动的动态监测也有望用于监测患者在家庭环境中的进展，并最终提供反馈以防止步态冻结。
Background and purpose:Anticipatory postural adjustments (APAs), prior to step initiation, are bradykinetic in advanced Parkinson's disease (PD) and may be one of the factors associated with 'start hesitation'. However, little is known about APAs in the early stage of PD. In this study, we determined whether body-worn accelerometers could be used to characterize step initiation deficits in subjects with early-to-moderate, untreated PD.Methods:Eleven PD and 12 healthy control subjects were asked to take two steps. Postural adjustments were compared from center of pressure (COP) and from acceleration of the trunk at the center of mass level (L5).Results:Our findings show that APAs measured from the peak COP displacement toward the swing leg and the peak trunk acceleration toward the stance leg were smaller in untreated PD compared with control subjects. The magnitude of APAs measured from peak COP displacements and accelerations were correlated.Conclusion:These results suggest that quantitative analysis of step initiation from one accelerometer on the trunk could provide useful information for the characterization of patients in early stages of PD, when clinical evidence of start hesitation may not be detectable. Ambulatory monitoring of step initiation is also promising for monitoring patient progression in the home environment, and eventually providing feedback for preventing freezing of gait episodes.