Roemmich Ryan T, Field Adam M, Elrod Jonathan M, Stegemöller Elizabeth L, Okun Michael S, Hass Chris J
Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA.
Clin Biomech (Bristol). 2013 Jan;28(1):93-7. doi: 10.1016/j.clinbiomech.2012.09.005. Epub 2012 Oct 10.
Coordination between the upper and lower extremities is important to providing dynamic stability during human gait. Though limited, previous research has suggested that interlimb coordination may be impaired in persons with Parkinson's disease. We extend this previous work using continuous analytical techniques to enhance our understanding of interlimb coordination during gait in persons with Parkinson's disease.
Eighteen adults with Parkinson's disease and fifteen healthy older adults walked overground while undergoing three-dimensional motion capture. Ipsilateral and contralateral interlimb coordination between the sagittal shoulder and hip angles was assessed using cross-covariance techniques. Independent samples and paired samples t-tests compared measures of interlimb coordination between groups and between sides within the participants with Parkinson's disease, respectively. Pearson's correlations were applied to investigate associations between interlimb coordination measures and subscores of gait, posture, and bradykinesia on the Unified Parkinson's Disease Rating Scale.
Ipsilateral and contralateral interlimb coordination was reduced in persons with Parkinson's disease compared to the healthy older adults. Ipsilateral coordination between the upper and lower extremities more affected by disease was found to be negatively associated with clinical scores of gait and posture. Interlimb coordination was not significantly associated with clinical measures of bradykinesia.
Persons with Parkinson's disease exhibit reduced interlimb coordination during gait when compared to healthy older adults. These reductions in coordination are related to clinically-meaningful worsening of gait and posture in persons with PD and coordination of arm and leg movements should be considered in future research on gait therapy in this population.
上下肢之间的协调对于人类步态中的动态稳定性至关重要。尽管先前的研究有限，但已有研究表明帕金森病患者的肢体间协调性可能受损。我们采用连续分析技术扩展了先前的工作，以加深对帕金森病患者步态中肢体间协调性的理解。
18名帕金森病成年患者和15名健康老年人在进行三维运动捕捉时在地面行走。使用互协方差技术评估矢状面肩部和髋部角度之间的同侧和对侧肢体间协调性。分别采用独立样本和配对样本t检验比较帕金森病患者组间以及组内两侧的肢体间协调性测量值。应用皮尔逊相关性分析来研究肢体间协调性测量值与统一帕金森病评定量表中步态、姿势和运动迟缓子评分之间的关联。
与健康老年人相比，帕金森病患者的同侧和对侧肢体间协调性降低。发现受疾病影响更大的上下肢同侧协调性与步态和姿势的临床评分呈负相关。肢体间协调性与运动迟缓的临床测量值无显著关联。
与健康老年人相比，帕金森病患者在步态中表现出肢体间协调性降低。这些协调性的降低与帕金森病患者临床上有意义的步态和姿势恶化有关，并且在该人群未来的步态治疗研究中应考虑手臂和腿部运动的协调性。
