A biomechanical study of gait initiation in Huntington's disease
A biomechanical study of gait initiation in Huntington's disease
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DOI：
10.1016/j.gaitpost.2006.04.001
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发表时间：
2007-02-01
期刊：
影响因子：
2.4
通讯作者：
Defebvre, L.
中科院分区：
文献类型：
--
作者：
Delval, A.;Krystkowiak, P.;Defebvre, L.
背景资料：基底神经节疾病中的运动不能基本上被定义为延迟的运动启动，反应时间增加，并且受试者开始运动变得困难（甚至不可能）。步态启动的生物力学研究将有助于评估早期亨廷顿舞蹈病（HD）patients.Methods的运动不能的作用：我们记录了运动学，时空和角度参数（使用视频运动分析，力平台和光电系统）的前两步15 HD患者和15个性别和年龄匹配的控制。为了评估外部线索对步态启动参数的影响，我们研究了两种运动范式：自我触发启动和启动触发（提示）的“哔”声。我们分析了运动学，时空（速度，长度和持续时间的两个第一步）和角度参数（关节角度的范围）及其动力学数据（的压力中心（COP）的轨迹;的速度和轨迹的质量中心（COM））。患者自我触发步态比触发步态更困难。在HID中，预期姿势调整（APA）在自我触发步态启动比线索启动受损。事实上，动力学参数的改变揭示了在两种条件下第一步速度的降低。运动功能减退（评估的角度关节的范围内减少）发挥了所有重要的作用，在此reduction.Conclusion：运动不能是一个重要的功能受损的步态启动在HID。在HD自我触发启动的缺陷，这里看到符合一个假设，即缺乏内部线索可以取代所有外部触发。(c)2006 Elsevier B. V.保留所有权利。
Background: Akinesia in basal ganglia disorders is essentially defined by delayed movement initiatiom the reaction time increases and it becomes difficult (or even impossible) for the subject to initiate movement. A biomechanical study of gait initiation would help evaluate the role of akinesia in early stage Huntington's disease (HD) patients.Methods: We recorded kinematic, spatiotemporal and angular parameters (using video motion analysis, a force platform and an optoelectronic system) for the first two steps taken by 15 HD patients and 15 gender- and age-inatched controls. In order to evaluate the influence of an external cue on gait initiation parameters, we studied two movement paradigms: self-triggered initiation and initiation triggered (cued) by a "beep" sound. We analyzed kinematic, spatiotemporal (the speed, length and duration of the two first steps) and angular parameters (range of joint angles) its well as kinetic data (the trajectory of the centre of pressure (COP); the speed and trajectory of the centre of mass (COM)).Results: HD patients presented akinesia in both externally triggered and self-triggered conditions. Patients had more difficulties with self-triggered gait than with triggered gait. In HID, anticipatory Postural adjustments (APAs) were more impaired in self-triggered gait initiation than in cued initiation. Indeed, an alteration in the kinetic parameters revealed a reduction in first step speed in both conditions. Hypokinesia (as assessed by a reduction in the range of angle joints) played all important role in this reduction.Conclusion: Akinesia is a major feature of impaired gait initiation in HID. The deficiencies in self-triggered initiation in HD seen here fit with a hypothesis whereby deficient internal cueing can be replaced by all external trigger. (c) 2006 Elsevier B.V. All rights reserved.