Kang Gu Eon, Mickey Brian J, Krembs Barry S, McInnis Melvin G, Gross M Melissa
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States.
Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Department of Psychiatry, University of Michigan Medical School, School of Medicine, Ann Arbor, MI, United States.
J Biomech. 2019 Jan 3;82:266-270. doi: 10.1016/j.jbiomech.2018.10.039. Epub 2018 Nov 9.
The aim of this study was to investigate balance control during gait and sit-to-walk in individuals with bipolar disorder and healthy controls by examining the inclination angles between the whole-body center-of-mass (COM) and ankle in the sagittal plane. Twenty-one individuals with bipolar disorder in the euthymic (i.e., asymptomatic; n = 11) and depressed (n = 10) phases and 7 healthy controls (ages between 18 and 45) performed gait and sit-to-walk at self-selected comfortable speed. Mood phases for individuals with bipolar disorder were measured using the Patient Health Questionnaire and Altman Self-Rating Mania Scale. We collected motion data using a 16-camera motion capture technology. We found smaller COM-ankle inclination angles at seat-off during sit-to-walk for the bipolar-depressed group compared to the bipolar-euthymic and healthy groups, indicating poorly controlled balance for the bipolar-depressed group in sit-to-walk. However, we found larger COM-ankle inclination angles at beginning of single stance phase of gait for the bipolar-euthymic group compared to the healthy group, indicating well controlled balance for the bipolar-euthymic group in gait. Our results suggest an association between the depressed phase and balance impairment during daily movements in relatively young adults (ages ≤ 45 years). Our results also suggest that the depressed phase may be as detrimental to balance control as the effect of age-related neuromuscular weakness.
本研究旨在通过检查矢状面内全身质心（COM）与踝关节之间的倾斜角度，调查双相情感障碍患者和健康对照者在步态和从坐到走过程中的平衡控制情况。21名处于心境正常（即无症状；n = 11）和抑郁期（n = 10）的双相情感障碍患者以及7名健康对照者（年龄在18至45岁之间）以自我选择的舒适速度进行步态和从坐到走测试。使用患者健康问卷和阿尔特曼自我评定躁狂量表测量双相情感障碍患者的情绪阶段。我们使用16台摄像机的动作捕捉技术收集运动数据。我们发现，与双相情感障碍心境正常组和健康组相比，双相情感障碍抑郁组在从坐到走过程中离座时的COM-踝关节倾斜角度更小，这表明双相情感障碍抑郁组在从坐到走过程中的平衡控制较差。然而，我们发现，与健康组相比，双相情感障碍心境正常组在步态单支撑期开始时的COM-踝关节倾斜角度更大，这表明双相情感障碍心境正常组在步态中的平衡控制良好。我们的研究结果表明，在相对年轻的成年人（年龄≤45岁）中，抑郁期与日常活动中的平衡受损之间存在关联。我们的研究结果还表明，抑郁期对平衡控制的损害可能与年龄相关的神经肌肉无力的影响一样大。
