Phase-Dependent Effects of Closed-Loop Tactile Feedback on Gait Stability in Parkinson's Disease.
Phase-Dependent Effects of Closed-Loop Tactile Feedback on Gait Stability in Parkinson's Disease.
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DOI：
10.1109/tnsre.2020.2997283
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发表时间：
2020-07
期刊：
影响因子：
--
通讯作者：
Mancini M
中科院分区：
文献类型：
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作者：
Fino PC;Mancini M
帕金森病（PD）患者的步态障碍是功能依赖的主要原因，最近已被证明是PD患者跌倒、住院和死亡的最大危险因素。使用外部提示已成功改善PD患者的步态，但外部提示对步态稳定性的影响尚不清楚。我们研究了不同形式的线索，开环和闭环，是否影响步态的三个关键阶段的局部动态稳定性。43名成年PD患者在无提示(B)、开环提示（OL）、固定听觉提示（OL）、闭环提示（OL）、同侧足触地时手腕触觉反馈（CL）等提示条件下完成了6次2分钟的长步行试验。条件是在有和没有认知任务的情况下进行的。用惯性传感器记录运动数据。只有CL线索与躯干稳定性的变化有关，这些变化仅在步态的体重转移阶段明显。OL和CL都会导致整体步态速度、步幅长度和步幅时间的增加。虽然在体重转移过程中CL提示显著影响局部动态稳定性，但这些变化是否与全局稳定性相关尚不清楚。未来的研究将探讨其临床意义。
Gait disturbances in people with Parkinson’s disease (PD) are a major cause for functional dependence and have recently been shown to be the largest risk factor for falls, institutionalization and death in PD. The use of external cues has been successful at improving gait in people with PD, but the effect of external cues on gait stability is unclear. We examined whether different forms of cueing, open-loop and closed-loop, influenced the local dynamic stability of three critical phases of gait. Forty-three adults with PD completed six, two-minute long walking trials in the following cued conditions: no cue (B), open-loop cueing, fixed auditory cue (OL), closed-loop cueing, tactile feedback delivered to wrist when the ipsilateral foot contacted with the ground (CL). Conditions were performed with and without a cognitive task. Kinematic data were recorded with inertial sensors. Only CL cueing was associated with changes in trunk stability, and these changes were only evident during the weight transfer phase of gait. Both OL and CL caused reductions in overall gait speed, stride length, and an increase in stride time. While CL cueing significantly influenced local dynamic stability during weight transfer, it remains unknown whether these changes are associated with more or less global stability. Future research will explore the clinical implications.