Department of Neurology, Rochester, MN, United States of America.
Department of Orthopedic Surgery, Rochester, MN, United States of America.
J Neurol Sci. 2021 Oct 15;429:118054. doi: 10.1016/j.jns.2021.118054. Epub 2021 Aug 25.
Gait and balance abnormalities are a significant source of morbidity and mortality in progressive supranuclear palsy (PSP). Gait impairment in PSP is primarily assessed clinically on exam or with the use of rating scales. Three dimensional video based gait and balance analysis performed in a laboratory setting is a highly accurate method of motion analysis (Wren et al., 2020), however limited data is available in patients with PSP.
In this study we assess the objective features of postural control, kinematics, kinetic and temporal-spatial gait metrics in PSP, using three-dimensional video motion analysis in a laboratory setting compared to normal controls.
Three-dimensional motion was captured using a 10-camera motion capture system, 41 body markers and ground embedded force plates in 16 patients with PSP patients and compared to motorically normal controls.
Spatiotemporal, kinematic, and kinetic gait measures effectively differentiated patients with PSP from controls. Patients had slower gait velocity, lower cadence, increased double support time and abnormal antero-posterior sway. Joint kinematics and kinetics were reduced and showed less variation among patients with PSP compared to controls which is suggestive of bradykinesia. Objective gait measures of abnormality correlated with clinical disease severity. Postural sway metrics distinguished PSP from controls and captured gait imbalance.
Objective measures of gait and balance abnormalities in patients with PSP provide an outcome measure that can be potentially used for early disease detection, in clinical trials and to validate portable motion capture devices in the future.
步态和平衡异常是进行性核上性麻痹（PSP）发病率和死亡率的重要原因。PSP 患者的步态损害主要通过临床检查或使用评分量表进行评估。在实验室环境中使用基于三维视频的步态和平衡分析是一种非常精确的运动分析方法（Wren 等人，2020 年），但在 PSP 患者中可用的数据有限。
在这项研究中，我们使用实验室中的三维视频运动分析评估姿势控制、运动学、动力学和时空步态指标的客观特征，将 PSP 患者与正常对照组进行比较。
使用 10 个摄像机运动捕捉系统、41 个身体标记和地面嵌入式力板对 16 名 PSP 患者和运动正常的对照组进行三维运动捕捉。
时空、运动学和动力学步态测量有效地将 PSP 患者与对照组区分开来。患者的步行速度较慢，步频较低，双支撑时间增加，前后摆动异常。与对照组相比，关节运动学和动力学降低，且 PSP 患者之间的变化较小，提示为运动迟缓。异常的客观步态测量与临床疾病严重程度相关。姿势摆动指标将 PSP 与对照组区分开来，并捕捉到步态失衡。
PSP 患者步态和平衡异常的客观测量提供了一种可能用于早期疾病检测、临床试验以及未来验证便携式运动捕捉设备的结果测量。
