Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
Clin Neurol Neurosurg. 2020 May;192:105713. doi: 10.1016/j.clineuro.2020.105713. Epub 2020 Feb 3.
Nocturnal hypokinesia commonly affects Parkinson's disease (PD) patients, manifesting primarily as an impaired ability to turn in bed and sleeping in specific positions, such as prone that potentially poses the risk of positional asphyxia.
To objectively evaluate, using axial inertial sensors (the NIGHT-Recorder), the ability of PD patients and controls to turn in bed from prone to supine position and to correlate these parameters with disease severity scores.
Turning in bed from prone to supine position was assessed in 16 PD patients with a moderate disease stage and 16 age-matched controls using the NIGHT-Recorder. Successful turning was defined as a full 180 ° turn from prone to supine position as evidenced by the NIGHT-Recorder. Objective parameters included duration, velocity, and acceleration of turn. The ability to turn in bed was determined by torque per kilogram body weight (T/kg).
Two out of 16 PD patients (12.5%) could not initiate their turns. PD patients turned with a significant longer duration (p = 0.04), slower velocity (p = 0.04), and acceleration (p = 0.04) compared to controls. Although PD patients had lower T/kg than controls, the difference was not significant. Several significant correlations were demonstrated between turning parameters and clinical rating scales (Duration vs. UPDRS axial: r=0.51, p = 0.04; T/kg vs. PDSS-2: r=0.53, p = 0.03; T/kg vs. NHQ: r=0.52, p = 0.03).
Our study provides objective evidence of impaired turning in bed from prone to supine position in PD patients with nocturnal hypokinesia. Appropriate measures should be taken to improve nocturnal mobility in those at risk.
夜间运动减少症常影响帕金森病（PD）患者，主要表现为在床上翻身和保持特定姿势（如俯卧位）的能力受损，这可能会增加体位性窒息的风险。
使用轴向惯性传感器（NIGHT-Recorder）客观评估 PD 患者和对照组从俯卧位转为仰卧位的翻身能力，并将这些参数与疾病严重程度评分相关联。
使用 NIGHT-Recorder 评估 16 名处于中度疾病阶段的 PD 患者和 16 名年龄匹配的对照组从俯卧位转为仰卧位的翻身能力。翻身成功定义为通过 NIGHT-Recorder 充分完成 180°从俯卧位到仰卧位的翻身。客观参数包括翻身的持续时间、速度和加速度。翻身能力由每公斤体重扭矩（T/kg）确定。
16 名 PD 患者中有 2 名（12.5%）无法开始翻身。与对照组相比，PD 患者翻身的持续时间明显更长（p=0.04）、速度更慢（p=0.04）、加速度更低（p=0.04）。尽管 PD 患者的 T/kg 低于对照组，但差异无统计学意义。一些重要的相关性在翻身参数和临床评分量表之间得到了证明（持续时间与 UPDRS 轴性评分：r=0.51，p=0.04；T/kg 与 PDSS-2：r=0.53，p=0.03；T/kg 与 NHQ：r=0.52，p=0.03）。
我们的研究提供了客观证据，表明夜间运动减少症的 PD 患者从俯卧位转为仰卧位的翻身能力受损。应采取适当措施来改善那些处于风险中的患者的夜间活动能力。
