Mirahmadi Mina, Karimi Mohammad Taghi, Esrafilian Amir
Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Eur Neurol. 2018;80(5-6):261-267. doi: 10.1159/000497041. Epub 2019 Feb 7.
Postural instability is a common disorder in Parkinson's disease (PD). The aim of this study was to evaluate stance stability of the subjects at the early stage of PD with both linear and nonlinear approaches. Moreover, this study aimed to find the effect of visual control on quiet stance postural control in these patients.
Seventeen PD patients (Hoehn/Yahr scale: 1) and 17 healthy control subjects were instructed to maintain quiet postural stance in 2 conditions (opened eyes and closed eyes). Four linear (excursion, path length, velocity, root mean square) and 1 nonlinear (approximate entropy) center of pressure (COP) parameters were calculated. A 2 × 2 mixed ANOVA was used for the final analysis.
Although there was no difference between the stability of PD patients and healthy control subjects based on excursion of COP in both mediolateral (ML) and anteroposterior (AP) directions, other linear parameters (path length of COP sways, velocity of COP sways, and root mean square in both ML and AP planes) showed that PD patients were significantly unstable compared to normal subjects (p value < 0.05). Vision influenced the stability of both groups significantly. The interaction of vision and group was not significant based on linear and nonlinear stability parameters.
Although patients in the early stage of PD seem to be unstable based on COP linear measures, their postural control system is still flexible to adapt to environmental perturbations in quiet stance and they are not more visually dependent than healthy subjects to control stability in this position.
姿势不稳是帕金森病(PD)的常见病症。本研究旨在采用线性和非线性方法评估PD早期患者的站立稳定性。此外,本研究旨在探究视觉控制对这些患者安静站立姿势控制的影响。
17例PD患者(Hoehn/Yahr分级:1级)和17名健康对照者被要求在两种条件下(睁眼和闭眼)保持安静的姿势站立。计算了四个线性(偏移、路径长度、速度、均方根)和一个非线性(近似熵)压力中心(COP)参数。最终分析采用2×2混合方差分析。
尽管基于COP在内外侧(ML)和前后(AP)方向的偏移,PD患者与健康对照者的稳定性无差异,但其他线性参数(COP摆动的路径长度、COP摆动的速度以及ML和AP平面的均方根)显示,与正常受试者相比,PD患者明显不稳定(p值<0.05)。视觉对两组的稳定性均有显著影响。基于线性和非线性稳定性参数,视觉与组别的交互作用不显著。
尽管基于COP线性测量,PD早期患者似乎不稳定,但他们的姿势控制系统在安静站立时仍能灵活适应环境扰动,并且在控制该姿势的稳定性方面,他们并不比健康受试者更依赖视觉。