Geriatric Research Education and Clinical Centers, Malcom Randall VA Medical Center, Gainesville, Florida (J.W.S.); and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (E.A.C., C.J.H.).
J Neurol Phys Ther. 2019 Jan;43(1):56-62. doi: 10.1097/NPT.0000000000000244.
Adequate lower limb strength and motor control are essential for mobility and quality of life. People with Parkinson disease (PD) experience a significant and progressive decline in motor capabilities as part of this neurodegenerative disease. The primary objective of this study was to examine the effect of PD on (1) muscular strength and (2) force steadiness in muscles that are primarily responsible for locomotion and stability.
Thirteen persons with PD and 13 healthy age-matched controls participated. Participants performed maximal and submaximal (5%, 10%, and 20% maximum voluntary contractions) isometric force tasks with the limb stabilized in a customized device. Strength of the hip extensors and flexors, hip abductors and adductors, and ankle plantar flexors and dorsiflexors was quantified based on data obtained from force transducers, with the relevant joint stabilized in standardized positions.
Individuals with PD were weaker and exhibited higher amounts of force variability than controls across the lower extremity. Reduced strength was greatest in the hip flexors (2.0 N/kg vs 2.6 N/kg) and ankle plantar flexors (1.74 N/kg vs 2.64 N/kg) and dorsiflexors (1.9 N/kg vs 2.3 N/kg). Force steadiness was impaired in the hip flexors, ankle plantar flexors, and dorsiflexors.
Reduced maximal force production was concomitant with impaired force control within the muscles that are critical for effective ambulation (hip flexion, ankle dorsiflexion, and ankle plantar flexion). These features should be evaluated when considering contributors to reduced mobility and quality of life.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A241).
足够的下肢力量和运动控制能力对于移动能力和生活质量至关重要。患有帕金森病（PD）的人在这种神经退行性疾病中，运动能力会显著且逐渐下降。本研究的主要目的是检查 PD 对（1）肌肉力量和（2）负责运动和稳定性的主要肌肉的力稳定性的影响。
13 名 PD 患者和 13 名年龄匹配的健康对照者参与了研究。参与者在定制设备中稳定肢体的情况下，进行了最大和次最大（5%、10%和 20%最大自主收缩）等长力任务。根据力传感器获得的数据，通过将相关关节稳定在标准化位置，量化了髋伸肌和屈肌、髋外展肌和内收肌以及踝跖屈肌和背屈肌的力量。
与对照组相比，PD 患者整个下肢的力量更弱，力变异性更高。髋屈肌（2.0 N/kg 对 2.6 N/kg）和踝跖屈肌（1.74 N/kg 对 2.64 N/kg）和背屈肌（1.9 N/kg 对 2.3 N/kg）的力量下降最大。髋屈肌、踝跖屈肌和背屈肌的力稳定性受损。
最大力量产生减少与对有效步行至关重要的肌肉（髋屈曲、踝背屈和踝跖屈）的力控制受损同时发生。在考虑导致移动能力和生活质量下降的因素时，应评估这些特征。视频摘要可从作者处获得更多见解（请观看视频，补充数字内容 1，可在以下网址获得：http://links.lww.com/JNPT/A241）。
