帕金森病和左旋多巴对稳定性功能极限的影响。
Effects of Parkinson's disease and levodopa on functional limits of stability.
作者信息
Mancini Martina, Rocchi Laura, Horak Fay B, Chiari Lorenzo
机构信息
Biomedical Engineering Unit, Department of Electronics, Computer Science and Systems, Alma Mater Studiorum, Universita' di Bologna, Viale Risorgimento 2, 40136 Bologna, Italy.
出版信息
Clin Biomech (Bristol). 2008 May;23(4):450-8. doi: 10.1016/j.clinbiomech.2007.11.007. Epub 2007 Dec 21.
BACKGROUND
The voluntary, maximum inclined posture reflects the self-perceived limits of stability. Parkinson's disease is associated with small, bradykinetic postural weight shifts while standing but it is unclear whether this is due to reduced limits of stability and/or to the selection of abnormal strategies for leaning. The aim of this study was to investigate the effects of Parkinson's disease and levodopa medication on voluntary limits of stability and strategies used to reach these limits.
METHODS
Fourteen subjects with Parkinson's disease (OFF and ON levodopa) and 10 age-matched controls participated in the study. Functional limits of stability were quantified as the maximum center of pressure excursion during voluntary forward and backward leaning. Postural strategies to achieve functional limits of stability were assessed by (i) body segments alignment, (ii) the difference between center of pressure and center of mass in preparation for a lean, (iii) the timing and the velocity of the preparation phase.
FINDINGS
Functional limits of stability were significantly smaller in subjects with Parkinson's disease compared to control subjects. Subjects with Parkinson's disease maintained their stooped posture while leaning, initiated leaning with a smaller difference between center of pressure and center of mass and had a slower leaning velocity compared to control subjects. Levodopa enlarged the limits of stability in subjects with Parkinson's disease because of an increase in maximum forward, but not backward leans, but did not significantly improve postural alignment, preparation for a leaning movement, or velocity of leaning.
INTERPRETATION
Parkinson's disease reduces functional limits of stability as well as the magnitude and velocity of postural preparation during voluntary, forward and backward leaning while standing. Levodopa improves the limits of stability but not the postural strategies used to achieve the leaning.
背景
自愿性最大倾斜姿势反映了自我感知的稳定极限。帕金森病与站立时微小、运动迟缓的姿势性体重转移有关，但尚不清楚这是由于稳定极限降低和/或选择了异常的倾斜策略所致。本研究的目的是调查帕金森病和左旋多巴药物治疗对自愿性稳定极限以及达到这些极限所采用策略的影响。
方法
14名帕金森病患者（未服用和服用左旋多巴）和10名年龄匹配的对照者参与了本研究。将稳定功能极限量化为自愿向前和向后倾斜时压力中心的最大偏移。通过以下方式评估实现稳定功能极限的姿势策略：（i）身体节段对齐，（ii）倾斜准备过程中压力中心与质心之间的差异，（iii）准备阶段的时间和速度。
研究结果
与对照者相比，帕金森病患者的稳定功能极限显著更小。与对照者相比，帕金森病患者在倾斜时保持弯腰姿势，开始倾斜时压力中心与质心之间的差异更小，倾斜速度更慢。左旋多巴扩大了帕金森病患者的稳定极限，原因是最大向前倾斜增加，但向后倾斜未增加，且未显著改善姿势对齐、倾斜运动准备或倾斜速度。
解读
帕金森病会降低站立时自愿向前和向后倾斜期间的稳定功能极限以及姿势准备的幅度和速度。左旋多巴改善了稳定极限，但未改善用于实现倾斜的姿势策略。
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