Esculier Jean-Francois, Vaudrin Joanie, Tremblay Louis E
Faculty of health sciences, School of rehabilitation, University of Ottawa, Ottawa, ON, Canada Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada.
Faculty of health sciences, School of rehabilitation, University of Ottawa, Ottawa, ON, Canada Hopital Hotel-Dieu d'Amos, Amos, QC, Canada.
J Parkinsons Dis. 2014;4(1):67-75. doi: 10.3233/JPD-130212.
Parkinson's disease (PD) is responsible for a progressive motor impairment. Wii Fit game represents an innovative treatment modality using external visual cueing, which can be used to help patients with PD in executing motor tasks and improving function.
The objectives of this study were (1) to compare lower limb corticomotor activation in subjects with and without PD during action observation (OBS), motor imagery (IMAG), and imitation (IMIT), and (2) to evaluate the effects of a 6-week training program using Wii Fit on corticomotor excitability during these 3 conditions.
Using transcranial magnetic stimulation, we assessed motor evoked potentials (MEPs) in Quadriceps Femoris (QF) and Soleus (SOL) muscles in 8 subjects with moderate PD (PD group) and 8 healthy subjects (HS group) before and after 6 weeks of training using Wii Fit during OBS, IMAG and IMIT of a mini-squat action.
At baseline, PD showed significantly less MEPs in QF during OBS, IMAG and IMIT compared with HS. In SOL, MEPs were reduced in PD only during IMIT. Following training, PD increased QF MEPs during OBS, which was opposite to the decrease in QF MEPs noted in HS. During IMAG, increased MEPs were found only in PD for SOL. During IMIT, both groups significantly reduced MEPs in both QF and SOL.
Subjects with PD may have improved their dual-task ability considering changes observed during OBS and IMIT. Visual cueing training using Wii Fit may provide an interesting rehabilitation method for PD.
帕金森病（PD）会导致进行性运动障碍。Wii Fit游戏是一种采用外部视觉提示的创新治疗方式，可用于帮助PD患者执行运动任务并改善功能。
本研究的目的是（1）比较PD患者与非PD患者在动作观察（OBS）、运动想象（IMAG）和模仿（IMIT）过程中下肢皮质运动激活情况，以及（2）评估使用Wii Fit进行为期6周的训练计划对这三种情况下皮质运动兴奋性的影响。
我们使用经颅磁刺激，在8名中度PD患者（PD组）和8名健康受试者（HS组）中，于使用Wii Fit进行迷你深蹲动作的OBS、IMAG和IMIT训练6周前后，评估股四头肌（QF）和比目鱼肌（SOL）的运动诱发电位（MEP）。
在基线时，与HS相比，PD患者在OBS、IMAG和IMIT过程中QF的MEP明显减少。在SOL中，仅在IMIT过程中PD患者的MEP降低。训练后，PD患者在OBS过程中QF的MEP增加，这与HS患者中QF的MEP降低相反。在IMAG过程中，仅PD患者的SOL中MEP增加。在IMIT过程中，两组的QF和SOL的MEP均显著降低。
考虑到在OBS和IMIT过程中观察到的变化，PD患者可能提高了他们的双任务能力。使用Wii Fit进行视觉提示训练可能为PD提供一种有趣的康复方法。
