Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
Institut de Neurosciences Des Systemès, Aix-Marseille University, Marseille, France.
Sci Rep. 2021 Feb 2;11(1):2736. doi: 10.1038/s41598-021-82348-4.
Parkinson's disease (PD) is characterized by motor impairment, affecting quality of life and increasing fall risk, due to ineffective postural control. To this day, the diagnosis remains based on clinical approach. Similarly, motor evaluation is based on heterogeneous, operator-dependent observational criteria. A synthetic, replicable index to quantify motor impairment is still lacking. Hence, we have designed a new measure of postural stability which assesses the trunk displacement in relation to the center of mass, that we named trunk displacement index (TDI). Twenty-three PD patients and twenty-three healthy controls underwent motor examination through a stereophotogrammetric system. A correlation analysis was performed to assess the relationship of TDI with gait parameters and clinical motor scale (UPDRS-III). The TDI sensitivity was estimated, comparing pre- and post- L-DOPA subclinical dose intake. The TDI showed significant correlations with many gait parameters and with the UPDRS-III. Furthermore, the TDI resulted capable in discriminating between off and on state in PD, whereas gait parameters failed two show any difference between those two conditions. Our results suggest that the TDI may be considered a highly sensitive biomechanical index, reflecting the overall motor condition in PD, and provided of clinical relevance due to the correlation with the clinical evaluation.
帕金森病(PD)的特征是运动障碍,由于姿势控制无效,影响生活质量并增加跌倒风险。迄今为止,诊断仍然基于临床方法。同样,运动评估也是基于异质的、依赖操作者的观察性标准。缺乏一种综合的、可复制的量化运动障碍的指标。因此,我们设计了一种新的姿势稳定性测量方法,该方法评估了与质心相关的躯干位移,我们将其命名为躯干位移指数(TDI)。23 名 PD 患者和 23 名健康对照者通过立体摄影测量系统进行了运动检查。进行了相关分析,以评估 TDI 与步态参数和临床运动量表(UPDRS-III)之间的关系。通过比较预和后亚临床剂量左旋多巴摄入,估计了 TDI 的敏感性。TDI 与许多步态参数和 UPDRS-III 呈显著相关。此外,TDI 能够区分 PD 患者的开和关状态,而步态参数在这两种状态之间没有显示出任何差异。我们的结果表明,TDI 可被视为一种高度敏感的生物力学指标,反映了 PD 中的整体运动状况,并且由于与临床评估相关,因此具有临床相关性。