Toosizadeh Nima, Mohler Jane, Lei Hong, Parvaneh Saman, Sherman Scott, Najafi Bijan
Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, United States of America.
Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, United States of America; Arizona Center on Aging, University of Arizona, Tucson, United States of America.
PLoS One. 2015 Apr 24;10(4):e0124763. doi: 10.1371/journal.pone.0124763. eCollection 2015.
Advances in wearable technology allow for the objective assessment of motor performance in both in-home and in-clinic environments and were used to explore motor impairments in Parkinson's disease (PD). The aims of this study were to: 1) assess differences between in-clinic and in-home gait speed, and sit-to-stand and stand-to-sit duration in PD patients (in comparison with healthy controls); and 2) determine the objective physical activity measures, including gait, postural balance, instrumented Timed-up-and-go (iTUG), and in-home spontaneous physical activity (SPA), with the highest correlation with subjective/semi-objective measures, including health survey, fall history (fallers vs. non-fallers), fear of falling, pain, Unified Parkinson's Disease Rating Scale, and PD stage (Hoehn and Yahr). Objective assessments of motor performance were made by measuring physical activities in the same sample of PD patients (n = 15, Age: 71.2±6.3 years) and age-matched healthy controls (n = 35, Age: 71.9±3.8 years). The association between in-clinic and in-home parameters, and between objective parameters and subjective/semi-objective evaluations in the PD group was assessed using linear regression-analysis of variance models and reported as Pearson correlations (R). Both in-home SPA and in-clinic assessments demonstrated strong discriminatory power in detecting impaired motor function in PD. However, mean effect size (0.94±0.37) for in-home measures was smaller compared to in-clinic assessments (1.30±0.34) for parameters that were significantly different between PD and healthy groups. No significant correlation was observed between identical in-clinic and in-home parameters in the PD group (R = 0.10-0.25; p>0.40), while the healthy showed stronger correlation in gait speed, sit-to-stand duration, and stand-to-sit duration (R = 0.36-0.56; p<0.03). This suggests a better correlation between supervised and unsupervised motor function assessments in healthy controls compared to PD group. In the PD group, parameters related to velocity and range-of-motion of lower extremity within gait assessment (R = 0.58-0.84), and turning duration and velocity within iTUG test (R = 0.62-0.77) demonstrated strong correlations with PD stage (p<0.01).
可穿戴技术的进步使得在家庭和临床环境中对运动表现进行客观评估成为可能，并被用于探索帕金森病（PD）的运动障碍。本研究的目的是：1）评估PD患者在临床和家庭环境中的步速、坐立和站立坐立持续时间之间的差异（与健康对照相比）；2）确定与主观/半客观测量（包括健康调查、跌倒史（跌倒者与非跌倒者）、跌倒恐惧、疼痛、统一帕金森病评定量表和PD分期（Hoehn和Yahr））相关性最高的客观身体活动测量指标，包括步态、姿势平衡、仪器化计时起立行走测试（iTUG）和家庭自发身体活动（SPA）。通过测量同一组PD患者（n = 15，年龄：71.2±6.3岁）和年龄匹配的健康对照（n = 35，年龄：71.9±3.8岁）的身体活动来进行运动表现的客观评估。使用线性回归方差分析模型评估PD组中临床和家庭参数之间以及客观参数与主观/半客观评估之间的关联，并以Pearson相关性（R）报告。家庭SPA和临床评估在检测PD患者运动功能受损方面均显示出强大的鉴别能力。然而，与PD组和健康组之间有显著差异的参数相比，家庭测量的平均效应大小（0.94±0.37）小于临床评估（1.30±0.34）。在PD组中，未观察到相同的临床和家庭参数之间有显著相关性（R = 0.10 - 0.25；p>0.40），而健康对照在步速、坐立持续时间和站立坐立持续时间方面显示出更强的相关性（R = 0.36 - 0.56；p<0.03）。这表明与PD组相比，健康对照中监督和非监督运动功能评估之间的相关性更好。在PD组中，步态评估中与下肢速度和运动范围相关的参数（R = 0.58 - 0.84）以及iTUG测试中的转身持续时间和速度（R = 0.62 - 0.77）与PD分期显示出强相关性（p<0.01）。
