The association between impaired turning and normal straight walking in Parkinson's disease
The association between impaired turning and normal straight walking in Parkinson's disease
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DOI：
10.1016/j.gaitpost.2007.04.010
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发表时间：
2007-07-01
期刊：
影响因子：
2.4
通讯作者：
Ferrarin, M.
中科院分区：
文献类型：
--
作者：
Crenna, P.;Carpinella, I.;Ferrarin, M.
通过步态分析，对一组帕金森病(PD)患者进行了步行时转弯的研究。帕金森病患者的临床症状轻微，稳态直线行走的步态参数和运动学没有明显异常。与年龄匹配的对照组相比，患者以较慢的步数接近转弯，以较多的步数完成转弯。此外，正常的头尾顺序，即头部朝向预期的移动方向旋转，然后是躯干的旋转，被第二个转弯步骤后几乎同时旋转的头部和躯干所取代，并减少了相对头部偏移量。有证据表明，在受轻微影响、正常行走的患者中，在转弯过程中节段间协调异常的证据表明，任务特定的病理生理机制与基本运动障碍无关，是帕金森病方向紊乱变化的基础。此外，与直线行走相比，与转弯相关的神经系统可能更容易受到与帕金森病相关的功能损害的影响。转向能力涉及的更高的控制水平可以解释观察到的意外联系。(C)2007 Elsevier B.V.保留所有权利。
Turning whilst walking was investigated by gait analysis in a group of Parkinson's Disease (PD) patients with mild clinical impairment and no significant abnormalities in stride parameters and kinematics of steady-state, linear walking. Comparison with age-matched controls demonstrated that patients approached turns with a slower step and completed turning with a greater number of steps. Moreover, the normal cranio-caudal sequence, whereby rotation of the head toward the intended direction of travel is followed by rotation of the trunk, was replaced by nearly simultaneous rotation of head and trunk and decreased relative head excursion after the second turning step. The evidence of abnormal inter-segmental coordination during turning in mildly affected, normally walking patients suggests that task-specific pathophysiological mechanisms, not necessary related to basic locomotor deficits, underlie disturbed directional changes in PD. Furthermore, turning-related neural systems may be more vulnerable to functional impairments associated with PD, as compared with linear walking. Hierarchically higher control levels involved in the turning ability may explain the observed unexpected association. (c) 2007 Elsevier B.V. All rights reserved.