Effect of Levodopa and Environmental Setting on Gait and Turning Digital Markers Related to Falls in People with Parkinson's Disease.
Effect of Levodopa and Environmental Setting on Gait and Turning Digital Markers Related to Falls in People with Parkinson's Disease.
复制标题
左旋多巴和环境设置对帕金森病患者步态和与跌倒相关的转向数字标记的影响。
DOI：
10.1002/mdc3.13601
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发表时间：
2023
影响因子：
4
通讯作者：
Horak,FayB
中科院分区：
文献类型：
--
作者：
Shah,VrutangkumarV;McNames,James;Carlson-Kuhta,Patricia;Nutt,JohnG;El-Gohary,Mahmoud;Sowalsky,Kristen;Mancini,Martina;Horak,FayB
目前尚不清楚在帕金森病患者（PD）中，药物状态（左旋多巴）或实验室环境与家庭环境是否在区分跌倒者和非跌倒者中起作用。目的探讨在临床和日常生活中，由穿戴式传感器获得的特定数字步态和转动测量，最能区分帕金森病患者的跌倒者和非跌倒者。方法：我们招募了34名PD患者（17名跌倒者和17名非跌倒者，基于过去6个月的跌倒经历）。受试者在实验室中分别在双脚和腰部佩戴三个惯性传感器，进行为期一周的步行任务（均为左旋多巴）和日常生活活动。我们从3分钟步行和日常生活中获得了24个数字测量值（18个步态和6个转身）。结果在临床上，跌倒者和非跌倒者在左旋多巴状态下收集的步态和转身指标均无显著差异。相比之下，在非左旋多巴状态下收集的数字测量在两组之间存在显著差异（平均转弯速度，完成一个转弯的平均步数和步态速度变异性，P< 0.03）。在日常生活中，跌倒者的平均转弯速度变异性与非跌倒者有显著差异（P= 0.023）。最后，完成一个回合的平均步数与患者报告的结果显著相关。结论：跌倒者与非跌倒者相比，在实验室中，在停药时和日常生活中，转动的数字测量不同，而不是步态。
BackgroundIt is unknown whether medication status (offandonlevodopa) or laboratory versus home settings plays a role in discriminating fallers and non‐fallers in people with Parkinson's disease (PD).ObjectivesTo investigate which specific digital gait and turning measures, obtained with body‐worn sensors, best discriminated fallers from non‐fallers with PD in the clinic and during daily life.MethodsWe recruited 34 subjects with PD (17 fallers and 17 non‐fallers based on the past 6 month's falls). Subjects wore three inertial sensors attached to both feet and the lumbar region in the laboratory for a 3‐minute walking task (bothoffandonlevodopa) and during daily life activities for a week. We derived 24 digital (18 gait and 6 turn) measures from the 3‐minute walk and from daily life.ResultsIn clinic, none of the gait and turning measures collected duringonlevodopa state were significantly different between fallers and non‐fallers. In contrast, digital measures collected in theofflevodopa state were significantly different between groups, (average turn velocity, average number of steps to complete a turn, and variability of gait speed,P< 0.03). During daily life, the variability of average turn velocity (P= 0.023) was significantly different in fallers than non‐fallers. Last, the average number of steps to complete a turn was significantly correlated with the patient‐reported outcomes.ConclusionsDigital measures of turning, but not gait, were different in fallers compared to non‐fallers with PD, in the laboratory whenoffmedication and during a daily life.