Jehu Deborah, Nantel Julie
Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada.
Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada.
Gait Posture. 2018 Sep;65:246-250. doi: 10.1016/j.gaitpost.2018.07.181. Epub 2018 Aug 3.
The relationship between falls and static and dynamic postural control has not been established in Parkinson's disease (PD). The purpose was to compare the compensatory postural strategies among fallers and non-fallers with PD as well as older adults during static and dynamic movements.
Twenty-five individuals with PD (11 fallers) and 17 older adults were outfitted with 6 accelerometers on the wrists, ankles, lumbar spine, and sternum, stood quietly for 30 s on a force platform, and walked back and forth for 30 s along a 15 m walkway. Root-mean-square displacement amplitude of the center of pressure (COP), COP velocity, gait spatial-temporal characteristics, trunk range of motion (ROM), and peak trunk velocities were obtained.
COP velocity in anterior-posterior was larger in older adults than those with PD (p < 0.05). Trunk frontal ROM and velocity were smaller in fallers and non-fallers with PD compared to older adults (p < 0.05). Trunk anterior-posterior ROM and velocity were smaller in fallers than non-fallers with PD and older adults (p < 0.05). In fallers with PD, negative correlations were shown between the sagittal trunk velocity and the COP velocity in the anterior-posterior direction as well as between trunk frontal velocity and COP velocity in both directions (p < 0.05). In non-fallers with PD, horizontal trunk ROM and velocity were positively correlated with COP ROM and velocity in the medial-lateral direction (p < 0.01).
Dynamic postural control revealed better discrimination between groups than static. Fallers and non-fallers with PD and older adults adopted different compensatory strategies during static and dynamic movements; thereby providing important information for falls-risk assessment.
帕金森病（PD）患者跌倒与静态和动态姿势控制之间的关系尚未明确。目的是比较PD患者中跌倒者和未跌倒者以及老年人在静态和动态运动过程中的代偿性姿势策略。
25名PD患者（11名跌倒者）和17名老年人在手腕、脚踝、腰椎和胸骨处佩戴6个加速度计，在测力平台上安静站立30秒，并沿15米长的通道来回行走30秒。获取压力中心（COP）的均方根位移幅度、COP速度、步态时空特征、躯干运动范围（ROM）和躯干峰值速度。
老年人前后方向的COP速度大于PD患者（p < 0.05）。与老年人相比，PD跌倒者和未跌倒者的躯干额状面ROM和速度较小（p < 0.05）。PD跌倒者的躯干前后ROM和速度比未跌倒的PD患者和老年人小（p < 0.05）。在PD跌倒者中，矢状面躯干速度与前后方向的COP速度之间以及躯干额状面速度与两个方向的COP速度之间呈负相关（p < 0.05）。在未跌倒的PD患者中，水平躯干ROM和速度与内外侧方向的COP ROM和速度呈正相关（p < 0.01）。
动态姿势控制在区分不同组之间比静态姿势控制表现更好。PD跌倒者和未跌倒者以及老年人在静态和动态运动过程中采用了不同的代偿策略；从而为跌倒风险评估提供重要信息。
