Cleveland Clinic, Department of Physical Medicine and Rehabilitation, Cleveland, OH, USA; Cleveland Clinic, Department of Biomedical Engineering, Cleveland, OH, USA; Youngstown State University, Youngstown, OH, USA.
Cleveland Clinic, Department of Biomedical Engineering, Cleveland, OH, USA.
Gait Posture. 2022 Oct;98:313-315. doi: 10.1016/j.gaitpost.2022.10.007. Epub 2022 Oct 15.
It is unknown if improvements in gait velocity following an aerobic cycling intervention are accompanied by improved gait biomechanics in individuals with Parkinson's disease (PD) or if gait abnormalities are exaggerated in response to increased velocity. Research question Can an 8-week aerobic cycling intervention elicit improvements in locomotor function in individuals with mild to moderate PD?
A secondary analysis of data from a randomized clinical trial was conducted in individuals with mild to moderate idiopathic PD (N = 28). Participants were randomized to an aerobic cycling intervention (PD N = 14) consisting of 24 sessions at a targeted aerobic intensity of 60-80% of heart rate reserve or to a no intervention control group (PD, N = 14). Change in comfortable walking speed in addition to gait kinematics, kinetics, and spatiotemporal variables using motion capture were obtained at baseline and end of treatment (EOT).
The PD group made significantly greater improvements in the primary outcome, change in comfortable gait velocity, from 0.86 ± 0.24 m/s at baseline to 1.00 ± 0.23 m/s at EOT compared to the PD group who declined from 0.91 ± 0.23 m/s at baseline to 0.80 ± 0.29 at EOT (P = 0.002). Improvements in gait velocity for the PD group were accompanied by improvements in gait kinematics, kinetics, and spatiotemporal parameters, while the PD group demonstrated slight worsening in all gait parameters over the 8-week period. Significance The 8-week moderate- to high-intensity cycling intervention elicited significantly greater improvements in gait velocity compared to the PD group. Increased gait velocity was accompanied by normalization of gait biomechanics, rather than an exaggeration of existing gait deviations. Aerobic cycling may be a viable treatment approach to improve gait velocity and gait biomechanics in individuals with mild to moderate PD and may mitigate declines in mobility.
尚不清楚有氧运动干预后步态速度的改善是否伴随着帕金森病(PD)患者步态生物力学的改善,或者在速度增加时步态异常是否会加剧。研究问题:8 周有氧运动干预是否能改善轻度至中度 PD 患者的运动功能?
对一项随机临床试验的数据分析进行了二次分析,纳入了轻度至中度特发性 PD 患者(N=28)。参与者被随机分配到有氧运动干预组(PD,N=14),包括 24 次以 60-80%心率储备为目标的有氧运动强度,或不干预对照组(PD,N=14)。在基线和治疗结束时(EOT),使用运动捕捉获得舒适步行速度以及步态运动学、动力学和时空变量的变化。
PD 组在主要结局(舒适步行速度的变化)方面取得了显著更大的改善,从基线时的 0.86±0.24m/s 增加到 EOT 时的 1.00±0.23m/s,而 PD 组则从基线时的 0.91±0.23m/s 下降到 EOT 时的 0.80±0.29m/s(P=0.002)。PD 组的步态速度改善伴随着步态运动学、动力学和时空参数的改善,而 PD 组在 8 周内所有步态参数都略有恶化。意义:8 周的中高强度骑行干预比 PD 组更显著地改善了步态速度。增加的步态速度伴随着步态生物力学的正常化,而不是现有步态偏差的加剧。有氧运动可能是改善轻度至中度 PD 患者步态速度和步态生物力学的可行治疗方法,并可能减缓运动能力的下降。