Arippa Federico, Leban Bruno, Monticone Marco, Cossu Giovanni, Casula Carlo, Pau Massimiliano
Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy.
Neurorehabilitation Unit, Department of Neuroscience and Rehabilitation, ARNAS "G. Brotzu", 09134 Cagliari, Italy.
Bioengineering (Basel). 2022 Mar 16;9(3):120. doi: 10.3390/bioengineering9030120.
Unilaterality of motor symptoms is a distinctive feature of Parkinson's Disease (PD) and represents an important co-factor involved in motor deficits and limitations of functional abilities including postural instability and asymmetrical gait. In recent times, an increasing number of studies focused on the characterization of such alterations, which have been associated with increased metabolic cost and risk of falls and may severely compromise their quality of life. Although a large number of studies investigated the gait alterations in people with PD (pwPD), few focused on kinematic parameters and even less investigated interlimb asymmetry under a kinematic point of view. This retrospective study aimed to characterize such aspects in a cohort of 61 pwPD (aged 68.9 ± 9.3 years) and 47 unaffected individuals age- and sex-matched (66.0 ± 8.3 years), by means of computerized 3D gait analysis performed using an optical motion-capture system. The angular trends at hip, knee and ankle joints of pwPD during the gait cycle were extracted and compared with those of unaffected individuals on a point-by-point basis. Interlimb asymmetry was assessed using angle-angle diagrams (cyclograms); in particular, we analyzed area, orientation, trend symmetry and range offset. The results showed that pwPD are characterized by a modified gait pattern particularly at the terminal stance/early swing phase of the gait cycle. Significant alterations of interlimb coordination were detected at the ankle joint (cyclogram orientation and trend symmetry) and at the hip joint (range offset). Such findings might be useful in clinical routine to characterize asymmetry during gait and thus support physicians in the early diagnosis and in the evaluation of the disease progression.
运动症状的单侧性是帕金森病（PD）的一个显著特征，是导致运动功能障碍和功能能力受限（包括姿势不稳和不对称步态）的一个重要协同因素。近年来，越来越多的研究聚焦于此类改变的特征描述，这些改变与代谢成本增加和跌倒风险相关，可能严重影响患者的生活质量。尽管大量研究调查了帕金森病患者（pwPD）的步态改变，但很少有研究关注运动学参数，从运动学角度研究肢体间不对称性的更是少之又少。这项回顾性研究旨在通过使用光学运动捕捉系统进行的计算机三维步态分析，对61名帕金森病患者（年龄68.9±9.3岁）和47名年龄及性别匹配的未受影响个体（66.0±8.3岁）的队列中的这些方面进行特征描述。提取帕金森病患者在步态周期中髋、膝和踝关节的角度变化趋势，并逐点与未受影响个体的趋势进行比较。使用角度-角度图（周期图）评估肢体间不对称性；具体而言，我们分析了面积、方向、趋势对称性和范围偏移。结果表明，帕金森病患者的特征是步态模式改变，特别是在步态周期的终末站立/早期摆动阶段。在踝关节（周期图方向和趋势对称性）和髋关节（范围偏移）检测到肢体间协调性的显著改变。这些发现可能有助于临床常规工作中对步态不对称性进行特征描述，从而辅助医生进行早期诊断和疾病进展评估。
