Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Neuroscience. 2011 May 19;182:217-24. doi: 10.1016/j.neuroscience.2011.02.061. Epub 2011 Mar 5.
The pathophysiology underlying freezing of gait (FOG) in Parkinson's disease remains incompletely understood. Patients with FOG ("freezers") have a higher temporal variability and asymmetry of strides compared to patients without FOG ("non-freezers"). We aimed to extend this view, by assessing spatial variability and asymmetry of steps and interlimb coordination between the upper and lower limbs during gait. Twelve freezers, 15 non-freezers, and 15 age-matched controls were instructed to walk overground and on a treadmill. Kinematic data were recorded with a motion analysis system. Both freezers and non-freezers showed an increased spatial variability of leg movements compared to controls. In addition, both patient groups had a deficit in interlimb coordination, not only between ipsilateral arms and legs, but also between diagonally positioned limbs. The only difference between freezers and non-freezers was a decreased step length during treadmill walking. We conclude that parkinsonian gait-regardless of FOG-is irregular, not only in the legs, but also with respect to interlimb coordination between the arms and legs. FOG is reflected by abnormal treadmill walking, presumably because this provides a greater challenge to the defective supraspinal control than overground walking, hampering the ability of freezers to increase their stride length when necessary.
冻结步态（FOG）在帕金森病中的病理生理学基础仍不完全清楚。与没有 FOG（“非冻结者”）的患者相比，FOG 患者的步伐时间变异性和不对称性更高。我们旨在通过评估步态中步幅和上下肢之间的空间变异性和不对称性以及四肢之间的协调来扩展这一观点。我们要求 12 名冻结者、15 名非冻结者和 15 名年龄匹配的对照者在地面和跑步机上行走。使用运动分析系统记录运动学数据。冻结者和非冻结者与对照组相比，腿部运动的空间变异性均增加。此外，两个患者组在肢体之间的协调方面都存在缺陷，不仅在同侧的手臂和腿部之间，而且在对角的肢体之间。冻结者和非冻结者之间唯一的区别是在跑步机上行走时步长减小。我们的结论是，帕金森步态——无论是否存在 FOG——不仅在腿部，而且在手臂和腿部之间的四肢协调方面都不规则。FOG 反映在异常的跑步机行走中，可能是因为这对有缺陷的中枢神经系统控制提出了更大的挑战，阻碍了冻结者在必要时增加步幅的能力，而地面行走则不会。
