Fernandes Ângela, Sousa Andreia S P, Rocha Nuno, Tavares João Manuel R S
1 University of Porto.
2 Polytechnic Institute of Porto.
Motor Control. 2017 Jul;21(3):249-264. doi: 10.1123/mc.2015-0032. Epub 2016 Aug 19.
The aim of this study was to compare postural control strategies during gait initiation in single- and dual-task conditions in individuals in early stages of Parkinson's Disease (PD). The activation timing of tibialis anterior occurred significantly later in the individuals with PD than in the controls (p = .05), and a significant interaction between the groups, conditions and limbs was found (p = .027). Differences between the single- and dual-task conditions were observed for the activation timing of the tibialis anterior (p = .042) and for the magnitude of soleus (p = .007), with lower values for the dual-task condition. Furthermore, not all the individuals followed the previously reported pattern of soleus inhibition followed by tibialis anterior activation. The duration of the mediolateral displacement of the center of pressure was longer in the individuals with PD than in the controls (p = .019). The anticipatory postural adjustments during gait initiation are impaired in PD and are expressed by an activation failure of tibialis anterior in both single- and dual-task conditions. Hence, it is important that during rehabilitation, intervention should concentrate on the tibialis anterior TA.
本研究的目的是比较帕金森病（PD）早期患者在单任务和双任务条件下步态起始时的姿势控制策略。PD患者胫前肌的激活时间显著晚于对照组（p = 0.05），并且发现组、条件和肢体之间存在显著交互作用（p = 0.027）。观察到单任务和双任务条件下胫前肌激活时间（p = 0.042）和比目鱼肌幅度（p = 0.007）存在差异，双任务条件下的值较低。此外，并非所有个体都遵循先前报道的比目鱼肌抑制后胫前肌激活的模式。PD患者压力中心的中外侧位移持续时间比对照组更长（p = 0.019）。PD患者在步态起始时的预期姿势调整受损，在单任务和双任务条件下均表现为胫前肌激活失败。因此，在康复过程中，干预应集中在胫前肌（TA）上，这一点很重要。
