Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne NE4 5PL, United Kingdom.
Gait Posture. 2013 Sep;38(4):790-4. doi: 10.1016/j.gaitpost.2013.03.024. Epub 2013 May 4.
Falls are common in idiopathic Parkinson's disease (PD) and frequently occur when walking and crossing obstacles.
To determine whether people with mild to moderately severe PD have abnormal centre of mass (CoM) motion in response to the perturbations of level-ground walking and obstacle crossing.
Mediolateral excursion and velocity of the CoM were measured using three-dimensional motion analysis and force platforms in 20 people with mild to moderately severe PD at the peak dose of their PD medication, and 20 age and sex matched healthy control participants.
People with PD had greater sideways sway than healthy older adults when walking, particularly when walking over obstacles. People with PD also maintained their CoM more medial to their stance foot throughout the swing phase of gait compared to controls. The severity of motor symptoms in people with PD, measured using the UPDRS-III, was associated with faster sideways CoM motion but not increased CoM excursions.
Environmental hazards, such as ground-based obstacles, may accentuate postural instability in people with PD. Increased mediolateral sway might be due to impaired postural responses or kinematic compensations to increase foot clearance. Fall prevention programs could benefit from inclusion of components educating people with PD about the risks associated with obstacle crossing when walking.
跌倒在特发性帕金森病（PD）中很常见，并且经常在行走和跨越障碍物时发生。
确定轻度至中度 PD 患者在平地上行走和跨越障碍物时，其质心（CoM）运动是否存在异常。
使用三维运动分析和力台，在 20 名处于 PD 药物峰值剂量的轻度至中度 PD 患者和 20 名年龄和性别匹配的健康对照参与者中，测量 CoM 的横向偏移和速度。
与健康老年人相比，PD 患者在行走时，尤其是在越过障碍物时，侧向摆动更大。与对照组相比，PD 患者在整个步态摆动阶段也将 CoM 保持在更靠近其支撑脚的内侧。PD 患者的运动症状严重程度，使用 UPDRS-III 进行测量，与 CoM 的更快侧向运动相关，但与 CoM 偏移增加无关。
环境危害，如地面障碍物，可能会加重 PD 患者的姿势不稳定。横向摆动增加可能是由于姿势反应受损或运动补偿以增加足清除。预防跌倒的计划可能受益于包括教育 PD 患者关于行走时跨越障碍物相关风险的内容。
