Center for the study of Movement, Cognition, and Mobility, Neurological Institute, Department of Neurology, Tel Aviv Sourasky Medical Center, 6 Weizmann street, 64239, Tel Aviv, Israel.
Graduate Training Centre of Neuroscience/ IMPRS for Cognitive and Systems Neuroscience, Tübingen, Germany.
J Neuroeng Rehabil. 2018 Jun 18;15(1):49. doi: 10.1186/s12984-018-0398-3.
Impairments in biomechanics and neural control can disrupt the timing and muscle pattern activation necessary for smooth gait. Gait is one of the most affected motor characteristics in Parkinson's disease (PD), but its smoothness has not been well-studied. This work applies the recently proposed spectral arc length measure (SPARC) to study, for the first time, gait in patients with PD. We hypothesized that the gait of patients with PD would be less smooth than that of healthy controls, as reflected in the SPARC measures.
The gait of 101 PD patients and 39 healthy controls was assessed using an inertial sensor. Smoothness of gait was estimated with SPARC (respectively from acceleration and angular velocity signals, SPARC-Acc and SPARC-Gyro) and harmonic ratios. Correlations between SPARC, traditional gait measures and the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS) were evaluated. Measurements and analysis were conducted with and without anti-PD medication.
SPARC measures were lower (less smooth) in PD than in controls (SPARC-Acc: PD: - 6.11 ± 0.74; CO: -5.17 ± 0.79; p < 0.001). When comparing PD to controls, SPARC-Acc differed more than other measures of gait (i.e., largest effect size, which was > 1). SPARC measures were correlated with UPDRS motor score (r = - 0.65), while they were independent of other measures of gait smoothness. PD gait in the on state was smoother than in the off state (p < 0.001).
SPARC calculated from trunk acceleration and angular velocity signals provide valid measures of walking smoothness in PD. SPARC is sensitive to Parkinson's disease and PD medications and can be used of as another, complementary measure of the motor control of walking in PD.
生物力学和神经控制的损伤会破坏平稳步态所需的时间和肌肉模式激活。步态是帕金森病（PD）最受影响的运动特征之一，但它的平稳性尚未得到很好的研究。这项工作应用最近提出的谱弧长测量（SPARC）首次研究 PD 患者的步态。我们假设 PD 患者的步态不如健康对照组平稳，这反映在 SPARC 测量中。
使用惯性传感器评估 101 名 PD 患者和 39 名健康对照者的步态。使用 SPARC（分别来自加速度和角速度信号，SPARC-Acc 和 SPARC-Gyro）和调和比来估计步态的平滑度。评估了 SPARC 与传统步态测量值和统一帕金森病评定量表（UPDRS）运动部分之间的相关性。在有和没有抗 PD 药物的情况下进行测量和分析。
PD 患者的 SPARC 测量值（更不平稳）低于对照组（SPARC-Acc：PD：-6.11±0.74；CO：-5.17±0.79；p<0.001）。与对照组相比，SPARC-Acc 的差异大于其他步态测量值（即最大效应量>1）。SPARC 测量值与 UPDRS 运动评分相关（r=-0.65），而与其他步态平滑度测量值无关。PD 在 ON 状态下的步态比在 OFF 状态下更平稳（p<0.001）。
从躯干加速度和角速度信号计算得出的 SPARC 提供了 PD 行走平稳性的有效测量值。SPARC 对帕金森病和 PD 药物敏感，可作为 PD 行走运动控制的另一种补充测量方法。
