对侧手激活增强帕金森强直。
Enhancement of parkinsonian rigidity with contralateral hand activation.
机构信息
Rehabilitation Science Research Laboratory, Department of Physical Therapy, Creighton University, Omaha, NE 68178, USA.
出版信息
Clin Neurophysiol. 2011 Aug;122(8):1595-601. doi: 10.1016/j.clinph.2011.01.010. Epub 2011 Feb 16.
OBJECTIVE
Quantify the enhancement of parkinsonian rigidity associated with a contralateral activation maneuver.
METHODS
Twelve subjects with PD and eight controls participated in the study protocol. Subjects' tested hand was displaced by a servo-motor throughout wrist flexion and extension motions of 60° without and with a concurrent gripping activation in the contralateral hand, referred to as Passive and Active conditions, respectively. Subjects with PD were tested in both OFF-MED and ON-MED states. Rigidity was quantified by integrating torque with position during both flexion and extension (torque resistance). ANOVA was performed to assess the effect of contralateral activation on rigidity.
RESULTS
PD patients had significantly (0.038) enhanced torque resistance in OFF-MED compared to healthy controls and ON-MED. In the Active condition, differences in torque resistance were magnified (p=0.002). Medication substantially reduced differences in torque resistance between controls and PD patients in the Passive and Active conditions.
CONCLUSIONS
A contralateral activation maneuver substantially increases rigidity in patients with PD, specifically the OFF-MED state. Rigidity is reduced with the application of dopaminergic medication, even with the presence of a contralateral activation maneuver.
SIGNIFICANCE
These data support the use of a contralateral activation maneuver as a tool in the diagnosis of PD.
目的
量化与对侧激活操作相关的帕金森强直的增强。
方法
12 名 PD 患者和 8 名对照者参与了研究方案。在不进行和同时进行对侧手紧握激活的情况下，通过伺服电机对手进行测试，分别称为被动和主动条件，测试对象的手在 60°的腕关节屈伸运动中被移位。PD 患者在 OFF-MED 和 ON-MED 状态下进行测试。通过在屈伸过程中整合扭矩和位置来量化刚性（扭矩阻力）。进行方差分析以评估对侧激活对刚性的影响。
结果
与健康对照者和 ON-MED 相比，PD 患者在 OFF-MED 时的扭矩阻力显著（0.038）增强。在主动条件下，扭矩阻力的差异放大（p=0.002）。在被动和主动条件下，药物治疗大大降低了对照组和 PD 患者之间扭矩阻力的差异。
结论
对侧激活操作可显著增加 PD 患者的刚性，特别是 OFF-MED 状态下的刚性。即使存在对侧激活操作，多巴胺能药物治疗也会降低刚性。
意义
这些数据支持将对侧激活操作作为 PD 诊断的工具。
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