Continuous monitoring of turning in Parkinson's disease: Rehabilitation potential
Continuous monitoring of turning in Parkinson's disease: Rehabilitation potential
复制标题
DOI：
10.3233/nre-151236
复制
发表时间：
2015-01-01
影响因子：
2
通讯作者：
Horak, Fay B.
中科院分区：
文献类型：
--
作者：
Mancini, Martina;El-Gohary, Mahmoud;Horak, Fay B.
背景：步态转身困难是帕金森病 (PD) 患者行动障碍、跌倒和生活质量下降的主要原因。不幸的是，诊所中的活动能力评估可能无法充分反映典型的活动功能或其在日常生活中的变异性。我们假设在连续 7 天的记录中，PD 患者的转身活动质量而不是总体活动量会受到损害。 方法：13 名 PD 受试者和 8 名年龄相仿的健康对照受试者在正常日常活动中连续 7 天佩戴三个 Opal 惯性传感器（在腰带上和每只脚上）。转弯指标包括以下各项的平均值和变异系数 (CV)：1) 每小时转数，2) 转弯角度幅度，3) 转弯持续时间，4) 转弯平均速度，以及 5) 每转步数。将连续监测期间的转动特征与观察步态任务中的 90 度和 180 度转动进行比较。结果：在观察到的转动方面，PD 组和对照组之间没有发现差异。相反，与健康对照受试者相比，患有PD的受试者表现出转弯质量受损（转弯平均速度：43.3 +/- 4.8度/秒与38 +/- 5.7度/秒，平均步数1.7 +/- 1.1与3.2 +/- 0.8）。此外，与对照组相比，PD 患者在一天内和几天内表现出更高的变异性。然而，在这 7 天内，帕金森症和对照受试者之间的总体活动（每天的步数或每日步行的百分比）没有差异。结论：我们表明，在家庭内外的日常活动中持续监测自然转身对于帕金森病患者和老年人来说是可行的。这是第一项研究表明，连续监测转弯比观察到的转弯对 PD 更敏感。此外，转弯特性的质量比转弯数量对PD更敏感。表征日常活动中的功能转向将解决康复实践和临床试验的一个关键障碍：现实生活环境中活动特征的客观测量。
BACKGROUND: Difficulty turning during gait is a major contributor to mobility disability, falls and reduced quality of life in patients with Parkinson's disease (PD). Unfortunately, the assessment of mobility in the clinic may not adequately reflect typical mobility function or its variability during daily life. We hypothesized that quality of turning mobility, rather than overall quantity of activity, would be impaired in people with PD over seven days of continuous recording.METHODS: Thirteen subjects with PD and 8 healthy control subjects of similar age wore three Opal inertial sensors (on their belt and on each foot) throughout seven consecutive days during normal daily activities. Turning metrics included average and coefficient of variation (CV) of: 1) number of turns per hour, 2) turn angle amplitude, 3) turn duration, 4) turn mean velocity, and 5) number of steps per turn. Turning characteristics during continuous monitoring were compared with turning 90 and 180 degrees in a observed gait task.RESULTS: No differences were found between PD and control groups for observed turns. In contrast, subjects with PD showed impaired quality of turning compared to healthy control subjects (Turn Mean Velocity: 43.3 +/- 4.8 degrees/s versus 38 +/- 5.7 degrees/s, mean number of steps 1.7 +/- 1.1 versus 3.2 +/- 0.8). In addition, PD patients showed higher variability within the day and across days compared to controls. However, no differences were seen between PD and control subjects in the overall activity (number of steps per day or percent of the day walking) during the seven days.CONCLUSIONS: We show that continuous monitoring of natural turning during daily activities inside or outside the home is feasible for patients with PD and the elderly. This is the first study showing that continuous monitoring of turning was more sensitive to PD than observed turns. In addition, the quality of turning characteristics was more sensitive to PD than quantity of turns. Characterizing functional turning during daily activities will address a critical barrier to rehabilitation practice and clinical trials: objective measures of mobility characteristics in real-life environments.