Anticipatory postural responses prior to protective steps are not different in people with PD who do and do not freeze.
Anticipatory postural responses prior to protective steps are not different in people with PD who do and do not freeze.
复制标题
对于进行和不进行冻结的帕金森病患者来说，采取保护措施之前的预期姿势反应没有不同。
DOI：
10.1016/j.gaitpost.2018.06.006
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发表时间：
2018
期刊：
影响因子：
2.4
通讯作者：
Mancini,M
中科院分区：
文献类型：
--
作者：
Peterson,DS;Lohse,KR;Mancini,M
背景失去平衡后的保护性踏步与福尔斯有关。保护性踏步前的预期姿势反应（APA）可能会影响踏步性能，PD患者可能会更大，并已被认为与步态冻结（FOG）有关。然而，PD和FOG患者是否（PD + FOG）比PD患者表现出更大的APA，并且没有FOG（PD-FOG）是未知的。研究问题：在采取保护措施之前确定冷冻状态对APA的影响，从而更好地了解FOG和APA之间的联系。（13个PD + FOG）暴露于50个支撑表面平移（25个向前，25个向后，随机顺序），产生保护步骤。通过测力板计算保护性步骤（即APA）前内外侧重量变化的大小以及阿帕试验的百分比。在测试时以及3.25（+/-0.43）年后评估FOG状态。结果和显著性对于前向和后向保护性踏步，阿帕试验的大小和百分比在PD + FOG和PD-FOG之间没有统计学差异，即使在从PD-FOG组中排除转换者之后也是如此（p > 0.27）。未观察到组与方向的相互作用。这些数据表明，在轻度至中度PD中，无法将APA与步进耦合，而不是尺寸不适当的阿帕，可能与步态冻结最相关。
BackgroundProtective stepping after a loss of balance is related to falls. Anticipatory postural responses (APAs) prior to protective stepping can impact step performance, may be larger in people with PD, and have been suggested to be related to freezing of gait (FOG). However, whether people with PD and FOG (PD + FOG) exhibit larger APAs than people with PD and no FOG (PD-FOG) is unknown.Research Question: Determine the impact of freezing status on APAs prior to protective steps, thus providing a better understanding of the link between FOG and APAs.MethodsTwenty-eight people with PD (13 PD + FOG) were exposed to 50 support surface translations (25 forward, 25 backward, random order) resulting in protective steps. The size of medio-lateral weight shifts prior to the protective step (i.e. APAs), and the percentage of trials with an APA were calculated via force-plates. FOG status was assessed at the time of testing as well as 3.25(+/-0.43) years later. Participants without FOG at testing, but with FOG at follow-up were identified as “converters”.Results and significanceFor both forward and backward protective stepping, size and percentage trials with an APA were not statistically different between PD + FOG and PD-FOG, even after excluding converters from the PD-FOG group (p > 0.27 for all). No group by direction interactions were observed. These data suggest that, in mild to moderate PD, an inability to couple APAs with stepping, rather than an inappropriately sized APA, may be most related to freezing of gait.