Department of Neurology, University of Minnesota, 516E. 717 Delaware Building. 717 Delaware St. SE, Minneapolis, MN, 55414, USA.
Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, 55414, USA.
J Neurol. 2023 Jan;270(1):386-393. doi: 10.1007/s00415-022-11375-6. Epub 2022 Sep 14.
This experiment tested if balance performance differed between a standardized treadmill surface perturbation task and a clinical pull test and was affected by medication or the presence of body weight support in people with Parkinson's disease (PD).
Twenty-seven individuals were tested (14 PD in both ON- and OFF-medication states). Clinical pull test and rapid forward (backward fall) translations of the support surface were applied to induce postural reactions requiring at least 1 step to restore balance. The effects of pull type (clinical vs. treadmill), partial bodyweight support (0 vs 20% body weight) and group (control, PD ON-meds and PD OFF-meds) on reactive stepping as well as practice/learning effect were examined. The number of steps taken and the first step duration were entered in linear repeated-measures mixed-effect models separately.
The effects of pull type, group, and bodyweight support were all significant in both metrics, as was ON- vs. OFF-medication. A significant interaction term (group x pull type) was found in the first step duration, showing that the group difference was greater in treadmill compared to the clinical pull test. A significant practice effect was also observed within and across testing sessions.
A standardized treadmill perturbation performed slightly better than the classical pull test in distinguishing between groups, and partial weight support did not substantially degrade the test's performance to detect the balance deficits in people with PD.
本实验测试了在帕金森病（PD）患者中，平衡性能是否在标准化跑步机表面扰动任务和临床拉力测试之间存在差异，以及是否受药物或体重支持的影响。
对 27 名个体进行了测试（14 名 PD 患者分别处于 ON- 和 OFF-药物状态）。应用临床拉力测试和快速向前（向后跌倒）平移支撑面，以诱发出至少需要 1 步才能恢复平衡的姿势反应。研究了拉力类型（临床 vs. 跑步机）、部分体重支持（0% vs. 20%体重）和组（对照组、PD ON-药物组和 PD OFF-药物组）对反应性跨步以及练习/学习效果的影响。线性重复测量混合效应模型分别记录了跨步的数量和第一步的持续时间。
在这两个指标中，拉力类型、组和体重支持的影响都是显著的，ON- 药物和 OFF- 药物的影响也是显著的。在第一步持续时间方面发现了一个显著的交互项（组 x 拉力类型），表明在跑步机上的组间差异大于临床拉力测试。还观察到了在测试期间内和跨测试期间的显著练习效果。
标准化跑步机扰动在区分组间方面略优于经典拉力测试，并且部分体重支持并未显著降低测试性能以检测 PD 患者的平衡缺陷。
