Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO 63108, USA.
Parkinsons Dis. 2013;2013:595378. doi: 10.1155/2013/595378. Epub 2013 Aug 21.
Purpose. Motor freezing, the inability to produce effective movement, is associated with decreasing amplitude, hastening of movement, and poor coordination. We investigated how manipulations of movement amplitude and cadence affect upper extremity (UE) coordination as measured by the phase coordination index (PCI)-only previously measured in gait-and freezing of the upper extremity (FO-UE) in people with Parkinson's disease (PD) who experience freezing of gait (PD + FOG), do not experience FOG (PD-FOG), and healthy controls. Methods. Twenty-seven participants with PD and 18 healthy older adults made alternating bimanual movements between targets under four conditions: Baseline; Fast; Small; SmallFast. Kinematic data were recorded and analyzed for PCI and FO-UE events. PCI and FO-UE were compared across groups and conditions. Correlations between UE PCI, gait PCI, FO-UE, and Freezing of Gait Questionnaire (FOG-Q) were determined. Results. PD + FOG had poorer coordination than healthy old during SmallFast. UE coordination correlated with number of FO-UE episodes in two conditions and FOG-Q score in one. No differences existed between PD-/+FOG in coordination or number of FO-UE episodes. Conclusions. Dyscoordination and FO-UE can be elicited by manipulating cadence and amplitude of an alternating bimanual task. It remains unclear whether FO-UE and FOG share common mechanisms.
运动冻结，即无法产生有效运动，与运动幅度减小、运动加快和协调不良有关。我们研究了运动幅度和节奏的变化如何影响上肢（UE）的协调，这仅以前在步态和帕金森病（PD）患者的上肢冻结（PD+FOG）中进行过测量，这些患者经历过步态冻结（FOG），而没有经历过 FOG（PD-FOG），以及健康对照组。方法：27 名 PD 患者和 18 名健康老年人在四种条件下进行交替的双手目标运动：基线；快速；小幅度；小幅度快速。记录运动学数据并分析相协调指数（PCI）和上肢冻结事件（FO-UE）。比较各组和各条件下的 PCI 和 FO-UE。确定 UE PCI、步态 PCI、FO-UE 和冻结步态问卷（FOG-Q）之间的相关性。结果：在小幅度快速运动时，PD+FOG 的协调能力比健康老年人差。在两种条件下，UE 协调与 FO-UE 发作次数相关，在一种条件下与 FOG-Q 评分相关。PD+/FOG 在协调或 FO-UE 发作次数上没有差异。结论：通过改变交替双手任务的节奏和幅度，可以引起协调障碍和上肢冻结。FO-UE 和 FOG 是否存在共同机制尚不清楚。
