McVey Molly A, Barnds Annaria N, Lyons Kelly E, Pahwa Rajesh, Mahnken Jonathan D, Luchies Carl W
a 1 Department of Mechanical Engineering , University of Kansas , Lawrence, Kansas , KS , USA.
b 2 Bioengineering, University of Kansas , Lawrence, Kansas , KS , USA.
Int J Neurosci. 2016 Aug;126(8):713-22. doi: 10.3109/00207454.2015.1094472. Epub 2015 Oct 15.
The purpose of this study is to characterize the base-width neutral step (BNS) as the first step in a compensatory step response in persons with moderate Parkinson's disease (PD), and its effect on balance recovery.
Ten PD and 10 healthy controls (HCs) responded to a posterior waist pull. A BNS was defined if the first step was less than 50 mm. The length, height, duration and velocity of the BNS and its effect on balance recovery time and center of mass location at recovery were compared to the first step within other stepping strategies (single step (SS), multiple step (MS)). A linear mixed model was used to compare across strategies.
Six of ten persons with PD compared to zero HC used a BNS. The BNS was shorter in length and duration compared to MS responses in HC, and shorter in duration compared to MS responses in PD. The BNS was slower in velocity compared to every other strategy. BNS use resulted in a longer recovery time compared to all strategies in HC and SS responses in PD, and trended toward a longer recovery time compared to MS responses in PD.
The BNS as the first step in a MS response may be an unreported strategy for compensatory stepping in PD. This study suggests that the cost of utilizing the BNS may be a longer time for recovery, but further work is necessary to understand the progression of the BNS as PD severity increases.
本研究旨在将基底宽度中性步(BNS)表征为中度帕金森病(PD)患者代偿性步反应中的第一步,并研究其对平衡恢复的影响。
10名帕金森病患者和10名健康对照者(HC)对腰部向后牵拉做出反应。若第一步小于50毫米,则定义为BNS。将BNS的长度、高度、持续时间和速度及其对恢复时平衡恢复时间和质心位置的影响与其他步策略(单步(SS)、多步(MS))中的第一步进行比较。采用线性混合模型对不同策略进行比较。
10名帕金森病患者中有6名使用了BNS,而10名健康对照者中无人使用。与健康对照者的多步反应相比,BNS的长度和持续时间更短;与帕金森病患者的多步反应相比,BNS的持续时间更短。与其他所有策略相比,BNS的速度更慢。在健康对照者中,与所有策略相比,以及在帕金森病患者的单步反应中,使用BNS导致恢复时间更长;在帕金森病患者中,与多步反应相比,使用BNS有恢复时间更长的趋势。
作为多步反应第一步的BNS可能是帕金森病代偿性步中一种未被报道的策略。本研究表明,采用BNS的代价可能是恢复时间更长,但随着帕金森病严重程度的增加,有必要进一步开展研究以了解BNS的进展情况。