Wang Yejun, Witchalls Jeremy, Preston Elisabeth, Wang Zhen, Zhuang Jie, Waddington Gordon, Adams Roger, Han Jia
Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.
Front Neurol. 2021 Jan 15;11:603814. doi: 10.3389/fneur.2020.603814. eCollection 2020.
Previous research has found ankle proprioception to be impaired in people with Parkinson's disease (PD). However, the relationship between ankle proprioception and functional mobility in people with PD has not been fully investigated. The purpose of this study was to examine whether ankle proprioception is related to the functional mobility of people with PD. Forty-two participants with mild to moderate PD volunteered. Ankle proprioceptive acuity was measured in standing, by using active movement extent discrimination assessment (AMEDA). Functional mobility measures included the timed-up-and-go test (TUG), 30 s sit-to-stand test (30s-STS) and 10-meter walking test (10MWT). Step length and step cadence were recorded during the 10MWT. No significant correlation was found between ankle proprioceptive discrimination scores and any mobility performance measure in people with PD (-0.20<r<0.04, all > 0.05). However, ankle proprioception scores were significantly correlated with step length ( = 0.38, < 0.05) and step cadence ( = -0.30, < 0.05), and were significantly and negatively correlated with the stage of modified Hoehn and Yahr (rho = -0.53, < 0.01). The lack of relationship between ankle proprioceptive acuity and functional mobility in PD suggests that people with PD may be more limited by reduced sensorimotor integration or may rely more on other sensory input, rather than ankle proprioception, to achieve functional mobility, a finding consistent with sensory reweighting theory. In addition, poorer ankle proprioceptive acuity was associated with decreased step length and increased step cadence, suggesting that the shuffling gait observed in PD may be related to impaired ankle proprioception, which has important clinical implications for gait retraining in people with PD. Given that ankle proprioception was significantly and negatively correlated with the stage of modified Hoehn and Yahr, it may warrant being used as an objective biomarker to monitor the progression of PD.
先前的研究发现，帕金森病（PD）患者存在踝关节本体感觉受损的情况。然而，PD患者踝关节本体感觉与功能活动能力之间的关系尚未得到充分研究。本研究的目的是检验踝关节本体感觉是否与PD患者的功能活动能力相关。42名轻度至中度PD患者自愿参与。通过主动运动幅度辨别评估（AMEDA）在站立位测量踝关节本体感觉敏锐度。功能活动能力测量包括计时起立行走测试（TUG）、30秒坐立测试（30s-STS）和10米步行测试（10MWT）。在10MWT过程中记录步长和步频。PD患者的踝关节本体感觉辨别分数与任何活动能力表现测量指标之间均未发现显著相关性（-0.20<r<0.04，均P>0.05）。然而，踝关节本体感觉分数与步长显著相关（r=0.38，P<0.05），与步频也显著相关（r=-0.30，P<0.05），并且与改良Hoehn和Yahr分期显著负相关（rho=-0.53，P<0.01）。PD患者踝关节本体感觉敏锐度与功能活动能力之间缺乏相关性，这表明PD患者可能更多地受到感觉运动整合能力下降的限制，或者在实现功能活动能力方面可能更多地依赖其他感觉输入，而非踝关节本体感觉，这一发现与感觉重新加权理论一致。此外，较差的踝关节本体感觉敏锐度与步长减小和步频增加有关，这表明PD患者中观察到的拖步步态可能与踝关节本体感觉受损有关，这对PD患者的步态再训练具有重要的临床意义。鉴于踝关节本体感觉与改良Hoehn和Yahr分期显著负相关，它可能有必要作为监测PD进展的客观生物标志物。
