帕金森病患者限时坐-站转移中的运动调整。
Motor adjustments during time-constrained sit-to-walk in people with Parkinson's disease.
机构信息
Neuroscience Research Australia, University of New South Wales, Sydney, Australia; School of Public Healthy and Community Medicine, University of New South Wales, Sydney, Australia; Universidade Estadual Paulista - UNESP, Instituto de Biociências de Rio Claro, Departamento de Educação Física, Posture and Gait Studies Laboratory, Rio Claro, São Paulo, Brazil.
Universidade Estadual Paulista - UNESP, Instituto de Biociências de Rio Claro, Departamento de Educação Física, Posture and Gait Studies Laboratory, Rio Claro, São Paulo, Brazil.
出版信息
Exp Gerontol. 2019 Sep;124:110654. doi: 10.1016/j.exger.2019.110654. Epub 2019 Jul 6.
INTRODUCTION
Sit-to-walk (STW) is a sequential task and a merge of sit-to-stand (STS) and gait initiation that are impaired in people with Parkinson's disease (PD). Performing sequential task under time constraint (e.g., stand up and walk to answer an urgent call) might influence people with PD due to their deficits on internal regulation of continuous, rhythmic and fast movements. It is known the PD behavior during STS and gait initiation tasks are impaired, however, little is known regarding PD behavior on STW. Thus, the aim of this study was to assess the motor behavior of people with PD and healthy older adults during the STW task under time constraint.
METHODS
Fourteen people with idiopathic PD and 14 healthy older adults (OA) participated in this study. They performed the STW task under a time constraint. STW performance (STW total duration, duration of each of the 4 phases of the STW, and the drop in the center of mass (COM) momentum, identified as Fluidity Index - FI), kinematics and kinetics outcomes were assessed throughout the task.
RESULTS
The PD group showed increased STW total time and lower FI, longer seat-off (Phase 1) time and first step (Phase 4) when compared to the OA group. Furthermore, the PD group showed more motor impairments (kinematics and kinetics) than the OA group throughout the task from seat-off until heel-off. Also, people with PD exhibited larger mediolateral COM displacement in the standing phase (Phase 2) and greater ground reaction force (GRF) in Phases 1 and 3.
CONCLUSIONS
We observed that people with PD exhibited more restrictions when compared with healthy older adults on their STW performance, COM and GRF parameters during the STW under time constraint. Some clinical impairments usually observed in people with PD might explain their STW performance such as, motor planning deficits, less automatic motor control and mediolateral balance impairments.
引言
坐站（STW）是一项序列任务，是坐站（STS）和步态启动的融合，在帕金森病（PD）患者中受到损害。由于他们在连续、有节奏和快速运动的内部调节方面存在缺陷，因此在时间限制下执行序列任务（例如，站起来并走过去接听紧急电话）可能会对 PD 患者产生影响。已知 PD 患者在 STS 和步态启动任务中的行为受到损害，但是，关于 PD 患者在 STW 中的行为知之甚少。因此，本研究旨在评估 PD 患者和健康老年人在时间限制下进行 STW 任务时的运动行为。
方法
14 名特发性 PD 患者和 14 名健康老年人（OA）参加了这项研究。他们在时间限制下进行 STW 任务。通过评估 STW 性能（STW 总持续时间、STW 的 4 个阶段中的每个阶段的持续时间以及质心（COM）动量的下降，即流动性指数-FI）、运动学和动力学结果来评估整个任务的表现。
结果
与 OA 组相比，PD 组的 STW 总时间增加，FI 降低，座椅分离（第 1 阶段）时间和第 1 步（第 4 阶段）时间延长。此外，与 OA 组相比，PD 组在整个任务中从座椅分离到脚跟分离时都表现出更多的运动障碍（运动学和动力学）。此外，PD 患者在站立阶段（第 2 阶段）的 COM 横向位移更大，在第 1 阶段和第 3 阶段的地面反作用力（GRF）更大。
结论
我们观察到，与健康老年人相比，PD 患者在时间限制下进行 STW 时，其 STW 性能、COM 和 GRF 参数受到更多限制。PD 患者中通常观察到的一些临床障碍可能解释了他们的 STW 表现，例如，运动规划障碍、较少的自动运动控制和横向平衡障碍。
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