Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Ontario, ON M5G 1V7, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, ON M5T 3M6, Canada.
Cells. 2022 May 11;11(10):1606. doi: 10.3390/cells11101606.
The physical impairments (e.g., slower walking speed) in patients with chronic obstructive pulmonary disease (COPD) have been attributed to peripheral characteristics (e.g., muscle atrophy). However, cognitive impairment may compromise motor control including walking automaticity. The objective of this study was to investigate PFC neural activity, evaluated using changes in oxygenated hemoglobin (ΔOHb), during preferred paced walking (PPW) in COPD patients and age-matched controls. The ΔOHb from the left and right dorsolateral PFC was measured using functional near-infrared spectroscopy. Fifteen COPD patients (age: 71 ± 8) and twenty age-matched controls (69 ± 7 years) participated. Two-way mixed ANOVA demonstrated that OHb in both groups decreased during PPW from the start (quintile 1; Q1) to the end (quintile 5; Q5) in the left dorsolateral and medial PFC. Q1 was comprised of the data during the first 20% of the task, while Q5 included data collected in the last 20% of the task duration. PPW duration ranged between 30.0 and 61.4 s in the control group and between 28.6 and 73.0 s in COPD patients. COPD patients demonstrated a higher OHb in Q5 compared to the negative OHb in controls in the right medial and dorsolateral PFC during PPW. PPW velocity was lower in COPD patients compared to controls (1.02 ± 0.22 vs. 1.22 ± 0.14 m/s, = 0.005). Healthy older controls exhibited automaticity during walking unlike patients with COPD. The lesser decrease in OHb in COPD patients may be attributed to increased executive demands or affect-related cues (e.g., pain or dyspnea) during walking.
慢性阻塞性肺疾病（COPD）患者的身体损伤（例如，行走速度较慢）归因于外周特征（例如，肌肉萎缩）。然而，认知障碍可能会影响运动控制，包括行走的自动性。本研究的目的是探讨 COPD 患者和年龄匹配的对照组在进行偏好性 paced walking（PPW）时，使用含氧血红蛋白（ΔOHb）变化评估的前额叶皮质（PFC）神经活动。使用功能近红外光谱测量左右背外侧前额叶皮质的ΔOHb。15 名 COPD 患者（年龄：71 ± 8 岁）和 20 名年龄匹配的对照组（69 ± 7 岁）参加了本研究。双向混合方差分析表明，两组患者的 OHb 在左背外侧和内侧前额叶皮质的 PPW 过程中均从开始（五分位数 1；Q1）到结束（五分位数 5；Q5）下降。Q1 包含任务前 20%的数据，而 Q5 包含任务持续时间最后 20%的数据。对照组的 PPW 持续时间在 30.0 和 61.4 s 之间，COPD 患者在 28.6 和 73.0 s 之间。与对照组的负 OHb 相比，COPD 患者在 PPW 期间的右内侧和背外侧前额叶皮质的 Q5 中表现出更高的 OHb。与对照组相比，COPD 患者的 PPW 速度较慢（1.02 ± 0.22 比 1.22 ± 0.14 m/s， = 0.005）。与 COPD 患者不同，健康的老年对照组在行走过程中表现出自动性。COPD 患者的 OHb 下降较少，可能归因于行走时执行需求增加或与情感相关的线索（例如，疼痛或呼吸困难）。
