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自动机械外周刺激对老年帕金森病患者步态生物力学的影响:一项随机交叉临床试验。

Effects of automatic mechanical peripheral stimulation on gait biomechanics in older adults with Parkinson's disease: a randomized crossover clinical trial.

机构信息

Center of Healthy Science, Universidade do Sagrado Coração, USC, Rua Irmã Arminda, 10-50, Bauru, SP, CEP: 17011-160, Brazil.

Department of Physical Education, São Paulo State University, UNESP, Bauru, Brazil.

出版信息

Aging Clin Exp Res. 2022 Jun;34(6):1323-1331. doi: 10.1007/s40520-022-02075-2. Epub 2022 Apr 6.

Abstract

BACKGROUND

Automated mechanical peripheral stimulation (AMPS) is a rehabilitation technique suggested to correct gait abnormalities on Parkinson's disease. Although previous studies have suggested increments in functional performance and gait speed after AMPS intervention, little is known about its effect on gait biomechanics.

OBJECTIVE

To analyze the effect of an AMPS session on functional performance and gait biomechanics in subjects with Parkinson's disease.

METHODS

Twenty-eight subjects aged 67±3 years old participated in this study. Kinematics and muscle activation were recorded during walking at a preferred gait speed before and after AMPS and sham interventions. Footswitches sensors were used to record the kinematic parameters. Electromyographic (EMG) signals of tibialis anterior (TA) and gastrocnemius lateralis (GL) were recorded. Timed up and go (TUG) test and Short Physical Performance Battery (SPPB) were performed to assess functional performance.

RESULTS

GL activation increased after AMPS intervention before and after heel strike (p = 0.04; p < 0.01) and before and after toe-off (p = 0.013; p = 0.038). Also, after AMPS intervention, TA activation increased after heel strike (p = 0.007); and after sham intervention, TA activation reduced before and after heel strike (p = 0.038; and p = 0.007) and before toe-off (p = 0.013). The time of TUG test was shorter after AMPS intervention (p = 0.015).

CONCLUSION

AMPS intervention changed the EMG activation of ankle muscles during walking and functional performance. However, AMPS intervention did not change gait kinematics.

摘要

背景

自动机械外周刺激(AMPS)是一种被建议用于纠正帕金森病步态异常的康复技术。尽管先前的研究表明 AMPS 干预后功能表现和步态速度有所提高,但对其对步态生物力学的影响知之甚少。

目的

分析 AMPS 治疗对帕金森病患者功能表现和步态生物力学的影响。

方法

28 名年龄 67±3 岁的受试者参与了这项研究。在进行 AMPS 和假干预之前和之后,以其惯用步态速度进行行走时,记录运动学和肌肉激活情况。使用足开关传感器记录运动学参数。记录胫骨前肌(TA)和腓肠外侧肌(GL)的肌电图(EMG)信号。进行计时起立行走测试(TUG)和简易体能状况量表(SPPB),以评估功能表现。

结果

在足跟触地(p=0.04;p<0.01)和足趾离地(p=0.013;p=0.038)之前和之后,AMPS 干预后 GL 激活增加。此外,在 AMPS 干预后,TA 在足跟触地后激活增加(p=0.007);在 sham 干预后,TA 在足跟触地(p=0.038;p=0.007)和足趾离地(p=0.013)之前和之后的激活减少。AMPS 干预后 TUG 测试的时间更短(p=0.015)。

结论

AMPS 干预改变了行走过程中踝关节肌肉的 EMG 激活和功能表现。然而,AMPS 干预并未改变步态运动学。

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