Huxham Frances, Baker Richard, Morris Meg E, Iansek Robert
Centre for Clinical Research Excellence in Gait Analysis and Gait Rehabilitation, Victoria, Australia.
Mov Disord. 2008 Jul 30;23(10):1391-7. doi: 10.1002/mds.21943.
Head and trunk axial rotation during walking to align with a new path are integral components of direction change (turning). Turning is problematic in people with Parkinson's disease (PD), who appear to move en-bloc when turning and when walking straight. Axial rotation has been little investigated in this group. Accordingly, head, thorax, and pelvis rotation relative to the laboratory axes (global rotation) was investigated in 10 patients with PD and 10 matched comparison subjects when walking straight and when turning 60 and 120 degrees . Data were selected at three footfalls before and three after a pole denoting the corner. Although rotation was reduced overall in patients with PD, final differences were minimized by rotation commencing at an earlier step in the patient group. When rotation was measured at various distances relative to the corner, the patient group demonstrated greater rotation than their peers. In support of clinical observations, patients constrained thorax and pelvis closely together around the corner, while control subjects maintained a pattern of reciprocal oscillation when turning. Stride length reduction appears to contribute more to inefficient turning in PD than under-scaled amplitude of rotation.
行走过程中头部和躯干的轴向旋转以与新路径对齐是方向改变（转弯）的重要组成部分。转弯对于帕金森病（PD）患者来说是个难题，他们在转弯和直行时似乎都是整体移动。该群体中轴向旋转的研究很少。因此，对10名PD患者和10名匹配的对照受试者在直行以及转弯60度和120度时相对于实验室坐标轴（整体旋转）的头部、胸部和骨盆旋转情况进行了研究。在表示转弯处的标杆之前三步和之后三步选取数据。尽管PD患者的旋转总体上有所减少，但通过患者组在更早的步幅开始旋转，最终差异被最小化。当在相对于转弯处的不同距离测量旋转时，患者组比其同龄人表现出更大的旋转。支持临床观察结果的是，患者在转弯处将胸部和骨盆紧紧地靠在一起，而对照组受试者在转弯时保持着一种相互摆动的模式。步幅缩短似乎比旋转幅度不足对PD患者转弯效率效率低下的转弯影响更大。
