Sasikumar Sanskriti, Sorrento Gianluca, Lang Anthony E, Strafella Antonio P, Fasano Alfonso
Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, UHN, Toronto, Ontario, Canada.
Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, UHN, Toronto, Ontario, Canada.
Neurobiol Dis. 2023 Jun 1;181:106109. doi: 10.1016/j.nbd.2023.106109. Epub 2023 Apr 3.
Split-belt treadmill (SBTM) training has been proposed to improve gait symmetry and overall gait performance of patients with Parkinson's disease (PD).
To determine whether patient's baseline features affect gait adaptation to SBTM in PD with freezing of gait (FOG).
Twenty participants with idiopathic PD and treatment-resistant FOG underwent several clinical assessments including the Toronto Cognitive Assessment (TorCA) prior to treadmill training. Velocity of the treadmill was adjusted to over-ground walking speed. During SBTM training, the belt velocity on the least-affected side was reduced by 25%.
Participants who adapted to SBTM training demonstrated cognitively intact TorCA scores (p < 0.001), particularly intact working memory (p < 0.001). After-effects correlated with normal total TorCA (p = 0.02), working memory and visuospatial (p < 0.001) function.
Cognitive impairment, particularly impaired working memory, reduces gait adaptation and after-effects in PD with FOG. This is informative for trials studying prolonged effects of SBTM training in FOG.
已提出使用分带跑步机（SBTM）训练来改善帕金森病（PD）患者的步态对称性和整体步态表现。
确定患者的基线特征是否会影响冻结步态（FOG）的PD患者对SBTM训练的步态适应性。
20名患有特发性PD和难治性FOG的参与者在跑步机训练前接受了多项临床评估，包括多伦多认知评估（TorCA）。跑步机速度调整为地面行走速度。在SBTM训练期间，受影响最小一侧的皮带速度降低25%。
适应SBTM训练的参与者表现出认知功能完整的TorCA评分（p<0.001），尤其是工作记忆完整（p<0.001）。后效应与正常的总TorCA（p=0.02）、工作记忆和视觉空间（p<0.001）功能相关。
认知障碍，尤其是工作记忆受损，会降低FOG的PD患者的步态适应性和后效应。这对研究SBTM训练在FOG中的长期效果的试验具有参考价值。
