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提高速度改善帕金森病患者在抓虚拟移动球时的手臂运动和站立姿势控制。

Increasing speed to improve arm movement and standing postural control in Parkinson's disease patients when catching virtual moving balls.

机构信息

Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan; Department of Rehabilitation, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan.

出版信息

Gait Posture. 2014 Jan;39(1):65-9. doi: 10.1016/j.gaitpost.2013.05.029. Epub 2013 Jul 3.

Abstract

Research has shown that moving targets help Parkinson's disease (PD) patients improve their arm movement while sitting. We examined whether increasing the speed of a moving ball would also improve standing postural control in PD patients during a virtual reality (VR) ball-catching task. Twenty-one PD patients and 21 controls bilaterally reached to catch slow-moving and then fast-moving virtual balls while standing. A projection-based VR system connected to a motion-tracking system and a force platform was used. Dependent measures included the kinematics of arm movement (movement time, peak velocity), duration of anticipatory postural adjustments (APA), and center of pressure (COP) movement (movement time, maximum amplitude, and average velocity). When catching a fast ball, both PD and control groups made arm movements with shorter movement time and higher peak velocity, longer APA, as well as COP movements with shorter movement time and smaller amplitude than when catching a slow ball. The change in performance from slow- to fast-ball conditions was not different between the PD and control groups. The results suggest that raising the speed of virtual moving targets should increase the speed of arm and COP movements for PD patients. Therapists, however, should also be aware that a fast virtual moving target causes the patient to confine the COP excursion to a smaller amplitude. Future research should examine the effect of other task parameters (e.g., target distance, direction) on COP movement and examine the long-term effect of VR training.

摘要

研究表明,运动目标有助于帕金森病(PD)患者改善坐姿下的手臂运动。我们研究了在虚拟现实(VR)接球任务中,增加运动球的速度是否也能改善 PD 患者的站立姿势控制。21 名 PD 患者和 21 名对照组患者在站立时分别伸手去接慢球和快球。使用了一个连接到运动跟踪系统和力平台的基于投影的 VR 系统。依赖指标包括手臂运动的运动学(运动时间、峰值速度)、预期姿势调整(APA)的持续时间以及中心压力(COP)的运动(运动时间、最大幅度和平均速度)。当接住快球时,PD 组和对照组的手臂运动都具有更短的运动时间和更高的峰值速度、更长的 APA,以及更短的运动时间和更小幅度的 COP 运动,而当接住慢球时则没有这些特点。从慢球到快球条件的性能变化在 PD 组和对照组之间没有差异。结果表明,提高虚拟运动目标的速度应该会增加 PD 患者手臂和 COP 的运动速度。然而,治疗师也应该注意到,快速的虚拟运动目标会导致患者将 COP 运动限制在较小的幅度内。未来的研究应该检查其他任务参数(例如,目标距离、方向)对 COP 运动的影响,并检查 VR 训练的长期效果。

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