Knee trembling during freezing of gait represents multiple anticipatory postural adjustments.
Knee trembling during freezing of gait represents multiple anticipatory postural adjustments.
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DOI：
10.1016/j.expneurol.2008.10.019
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发表时间：
2009-02
影响因子：
5.3
通讯作者：
Horak, Fay B.
中科院分区：
文献类型：
--
作者：
Jacobs, Jesse V.;Nutt, John G.;Carlson-Kuhta, Patricia;Stephens, Marilee;Horak, Fay B.
步态冻结（FoG）是一种发作性的短暂无法行走，延迟步态启动或中断正在进行的步态。FoG通常与膝盖的交替抖动相关联，临床上称为膝盖颤抖或原地颤抖。FoG和伴随的膝盖颤抖的病理生理学尚不清楚;一种假设是准备迈步时姿势调整受损。我们研究了预期姿势调整（APA）前的保护步骤引起的向前失去平衡在10名帕金森病（PD）受试者与显着的FoG和10名对照组。APA的幅度和时间是根据每只脚下的力板记录的垂直地面反作用力的变化确定的，并通过双侧内侧腓肠肌、胫骨前肌和阔筋膜张肌的肌电图记录来证实。对照组受试者采用单一阿帕，然后采用一步来完成保护性步骤，而PD受试者经常表现出多个交替APA，与FoG期间常见的膝关节颤抖共存，以及延迟、不充分或无步进。这些多重APA的发作没有延迟，并且与对照受试者表现出的单一APA相比，振幅相似或更大。这些观察结果表明，多个APA产生的膝关节颤抖通常与FoG和FoG与向前失去平衡是由于无法耦合正常的阿帕步进电机模式。
Freezing of gait (FoG) is an episodic, brief inability to step that delays gait initiation or interrupts ongoing gait. FoG is often associated with an alternating shaking of the knees, clinically referred to as knee trembling or trembling in place. The pathophysiology of FoG and of the concomitant trembling knees is unknown; impaired postural adjustment in preparation for stepping is one hypothesis. We examined anticipatory postural adjustments (APAs) prior to protective steps induced by a forward loss of balance in 10 Parkinson’s disease (PD) subjects with marked FoG and in 10 control subjects. The amplitude and timing of the APAs were determined from changes in the vertical ground-reaction forces recorded by a force plate under each foot and were confirmed by electromyographic recordings of bilateral medial gastrocnemius, tibialis anterior and tensor fascia latae muscles. Protective steps were accomplished with a single APA followed by a step for control subjects, whereas PD subjects frequently exhibited multiple, alternating APAs coexistent with the knee trembling commonly observed during FoG as well as delayed, inadequate or no stepping. These multiple APAs were not delayed in onset and were of similar or larger amplitude than the single APAs exhibited by the control subjects. These observations suggest that multiple APAs produce the knee trembling commonly associated with FoG and that FoG associated with a forward loss of balance is caused by an inability to couple a normal APA to the stepping motor pattern.
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影响因子：
14.5
作者：
BENECKE, R;ROTHWELL, JC;MARSDEN, CD
通讯作者：
MARSDEN, CD
影响因子：
2.5
作者：
Schepens, B;Drew, T
通讯作者：
Drew, T
影响因子：
8.6
作者：
ELBLE, RJ;MOODY, C;SINHA, R
通讯作者：
SINHA, R
影响因子：
8.6
作者：
Macht, Michael;Kaussner, Yvonne;Ellgring, Heiner
通讯作者：
Ellgring, Heiner
影响因子：
2
作者：
Jacobs, Jesse V.;Horak, Fay B.
通讯作者：
Horak, Fay B.