Mancini Martina, Weiss Aner, Herman Talia, Hausdorff Jeffrey M
Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR, United States.
Center for the Study of Movement, Cognition and Mobility, Neurology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Front Neurol. 2018 Jan 26;9:18. doi: 10.3389/fneur.2018.00018. eCollection 2018.
Difficulty in turning while walking is common among patients with Parkinson's disease (PD). This difficulty often leads to significant disability, falls, and loss of function; moreover, turning is a common trigger for freezing of gait (FoG). We hypothesized that the quantity and quality of turning mobility while walking during daily life would be different among subjects with PD with and without FoG. Here, we investigated, for the first time, the turning quality during daily life as it relates to FoG in people with PD using a single inertial sensor. Ninety-four subjects with PD (among whom 25 had FoG) wore an inertial sensor attached by a belt on the lower back during normal daily activity consecutively for 3 days. An algorithm identified periods of walking and calculated the number and quality metrics of turning. Quality, but not the quantity, of turning at home was different in freezers compared to the non-freezers. The number of turns (19.3 ± 9.2/30 min in freezers, 22.4 ± 12.9/30 min non-freezers; = 0.194) was similar in the two groups. Some aspects of quality of turns, specifically mean jerkiness, mean and variability of medio-lateral jerkiness were significantly higher ( < 0.05) in the freezers, compared to non-freezers. Interestingly, subjects with FoG showed specific turning differences in the turns with larger angles compared to those without FoG. These findings suggest that turning during daily activities among patients with PD is impaired in subjects with FoG, compared to subject without freezing. As such, clinical decision-making and rehabilitation assessment may benefit from measuring the quality of turning mobility during daily activities in PD.
行走时转身困难在帕金森病（PD）患者中很常见。这种困难常常导致严重残疾、跌倒和功能丧失；此外，转身是步态冻结（FoG）的常见诱因。我们假设，在日常生活中行走时，有和没有FoG的PD患者的转身移动数量和质量会有所不同。在此，我们首次使用单个惯性传感器研究了PD患者日常生活中与FoG相关的转身质量。94名PD患者（其中25名有FoG）在正常日常活动期间连续3天佩戴一个通过腰带系在下背部的惯性传感器。一种算法识别出行走时段并计算转身的数量和质量指标。与无冻结者相比，有冻结者在家中转身的质量而非数量存在差异。两组的转身次数相似（有冻结者为19.3±9.2次/30分钟，无冻结者为22.4±12.9次/30分钟；P = 0.194）。与无冻结者相比，有冻结者转身质量的某些方面，特别是平均急促度、中侧急促度的平均值和变异性显著更高（P < 0.05）。有趣的是，与无FoG者相比，有FoG的受试者在角度较大的转身中表现出特定的转身差异。这些发现表明，与无冻结的受试者相比，有FoG的PD患者在日常活动中的转身功能受损。因此，临床决策和康复评估可能受益于测量PD患者日常活动中转身移动的质量。
