Ryckewaert Gilles, Luyat Marion, Rambour Melanie, Tard Céline, Noël Myriam, Defebvre Luc, Delval Arnaud
Université de Lille, U1171, F-59037 Lille cedex, France; Department of Neurology, Lille University Medical Center, F-59037 Lille cedex, France.
Université de Lille, EA 4072, F-59650 Villeneuve d'Ascq, France.
Neurosci Lett. 2015 Mar 4;589:181-4. doi: 10.1016/j.neulet.2015.01.039. Epub 2015 Jan 16.
Falls frequently occur during daily activities such as reaching for an object in patients with Parkinson's disease (PD). Misjudgment is also reported to be one of the circumstances that lead to falls. The functional reach test is an indicator of dynamic balance. The primary objective was to establish whether there is a difference between self-perceived and actual ability to perform the functional reach test in patients with PD who have never fallen. Three groups of participants (all with no history of falls) were studied: young adults, elderly adults and PD patients. The participants first estimated their maximum reaching distance (but without performing the action, i.e. as a motor imagery task) and then actually performed the functional reach test (i.e. as a motor task). No significant overestimation or underestimation was observed. The reaching distance was lower in PD than in the two other groups. There were no differences between PD patients and elderly adults in terms of the forward centre of pressure displacement. Seven PD patients reported a fall in the year following the experiment. The fallers had a longer history of disease. Finally, PD patients adequately estimated their ability in the functional reach test and did not adopt an "at risk" strategy and appeared to be quite conservative (as were healthy elderly adults) in their postural control behavior. Ability to estimate self-performance is preserved in PD patients with no clinical impairments of postural control although they are at risk of future falls.
在帕金森病(PD)患者进行诸如伸手拿取物品等日常活动时,跌倒频繁发生。据报道,判断失误也是导致跌倒的情况之一。功能性伸展测试是动态平衡的一个指标。主要目的是确定从未跌倒过的PD患者在自我感知的和实际进行功能性伸展测试的能力之间是否存在差异。研究了三组参与者(均无跌倒史):年轻人、老年人和PD患者。参与者首先估计他们的最大伸展距离(但不执行动作,即作为一项运动想象任务),然后实际进行功能性伸展测试(即作为一项运动任务)。未观察到明显的高估或低估。PD患者的伸展距离低于其他两组。在压力中心向前位移方面,PD患者与老年人之间没有差异。7名PD患者在实验后的一年内报告发生了跌倒。跌倒者的病程更长。最后,PD患者能够充分估计他们在功能性伸展测试中的能力,没有采取“有风险”的策略,并且在姿势控制行为上似乎相当保守(与健康老年人一样)。尽管没有姿势控制临床损伤的PD患者有未来跌倒的风险,但他们估计自我表现的能力得以保留。