Department of Neurology & Parkinson's Disease Center, Guro Hospital, Korea University, 148 Gurodong-ro, Guro-gu, Seoul, Republic of Korea.
Department of Neurology & Parkinson's Disease Center, Guro Hospital, Korea University, 148 Gurodong-ro, Guro-gu, Seoul, Republic of Korea; Department of Neurology, Dobong Hospital, 720 Dobong-ro, Dobong-gu, Seoul, Republic of Korea.
Hum Mov Sci. 2019 Dec;68:102527. doi: 10.1016/j.humov.2019.102527. Epub 2019 Nov 2.
Arm swing asymmetry is commonly observed in early Parkinson's disease (PD) and has been found to be useful for early diagnosis. However, there are uncertainties about the nature of its relationships with gait parameters, especially shoulder and elbow motions. Therefore, this study explored how these relationships are different between PD and controls. Forty one early PD and 23 controls were included. Participants walked at self-selected speed for 3D motion analysis. Arm swing at the wrist (AS), temporospatial parameters and kinematics in elbow, shoulder and trunk were obtained. Amplitudes and asymmetries of these variables were compared between PD and control groups. PD group showed increased AS asymmetry, compared to controls. Multiple hierarchical regression analysis on AS asymmetry was conducted in order to investigate how PD influences on the relationship between AS asymmetry and other variables. In pooled data (PD and control group), asymmetries in elbow and shoulder range of motion (RoM) were significant predictors for AS asymmetry but walking speed and asymmetries in temporospatial parameters were not significant. Group effect (PD effect) was significantly mediated by only elbow RoM asymmetry. Interaction between group and elbow RoM asymmetry was statistically significant, indicating that group was an effect modifier for elbow RoM asymmetry effect on AS asymmetry. Conclusively, arm swing asymmetry measured at the wrist represents the involvement of PD effect on the unilateral and distal upper limb in early stage. These findings are helpful for future researches related to clinical applications and mechanisms of arm swing asymmetry in PD.
手臂摆动不对称在早期帕金森病（PD）中很常见，并且已被证明对早期诊断有用。然而，其与步态参数的关系性质尚不确定，尤其是肩部和肘部运动。因此，本研究探讨了 PD 和对照组之间这些关系的不同之处。纳入了 41 名早期 PD 患者和 23 名对照组。参与者以自我选择的速度行走，进行 3D 运动分析。获取了腕部的手臂摆动（AS）、时空参数和肘部、肩部和躯干的运动学。比较了 PD 和对照组之间这些变量的幅度和不对称性。与对照组相比，PD 组的 AS 不对称性增加。为了研究 PD 如何影响 AS 不对称性与其他变量之间的关系，对 AS 不对称性进行了多元层次回归分析。在汇总数据（PD 和对照组）中，肘部和肩部运动范围（RoM）的不对称性是 AS 不对称性的重要预测因子，但步行速度和时空参数的不对称性则不是。组效应（PD 效应）仅由肘部 RoM 不对称性显著介导。组与肘部 RoM 不对称性之间的交互作用具有统计学意义，表明组是肘部 RoM 不对称性对 AS 不对称性的影响的效应修饰剂。总之，在腕部测量的手臂摆动不对称性代表了 PD 效应在早期单侧和远端上肢的参与。这些发现有助于未来与 PD 中手臂摆动不对称性的临床应用和机制相关的研究。
