Marchese Roberta, Bove Marco, Abbruzzese Giovanni
Department of Neurological Sciences, Movement Disorder Unit, University of Genoa, Genoa, Italy.
Mov Disord. 2003 Jun;18(6):652-8. doi: 10.1002/mds.10418.
To analyse the effect of concomitant cognitive or motor task performance on balance control in Parkinson's disease (PD), we performed a posturographic study in 24 PD patients and in 20 sex- and age-matched control subjects. Postural sway was measured with eyes open (EO) and eyes closed (EC) during quiet stance and during performance of calculation or motor sequence of thumb opposition to the other fingers. No difference of centre of foot pressure (COP) parameters was observed during quiet standing (either EO or EC) between patients and controls, but visual deprivation induced in both groups a worsening of postural stability. COP area was significantly increased in PD patients during dual task performance, whereas no difference of COP path and x-y axes was observed. The effects induced by the performance of cognitive or motor task were significantly more evident in PD patients with clinical evidence of postural instability (presence of prior falls in the history). This study demonstrates that dual task interference on postural control can be observed in PD patients during performance of cognitive as well as motor tasks. The balance deterioration during dual task performance was significantly enhanced in patients with history of prior falls. These findings have some implications for the strategies to be used in reducing the risk of fall in PD.
为分析帕金森病（PD）患者同时进行认知或运动任务对平衡控制的影响，我们对24例PD患者及20例年龄和性别匹配的对照者进行了姿势描记研究。在安静站立时以及进行计算或拇指与其他手指对指的运动序列时，分别测量睁眼（EO）和闭眼（EC）状态下的姿势摆动。患者和对照组在安静站立（EO或EC）时足底压力中心（COP）参数无差异，但两组视觉剥夺均导致姿势稳定性恶化。在双重任务执行期间，PD患者的COP面积显著增加，而COP轨迹和x-y轴无差异。在有姿势不稳临床证据（既往有跌倒史）的PD患者中，认知或运动任务执行所引起的影响更为明显。本研究表明，在PD患者进行认知及运动任务时可观察到双重任务对姿势控制的干扰。既往有跌倒史的患者在双重任务执行期间平衡能力恶化显著增强。这些发现对降低PD患者跌倒风险的策略具有一定意义。
