Department of Kinesiology, California State University, Fullerton, Fullerton, CA, United States of America.
Department of Kinesiology, California State University, Fullerton, Fullerton, CA, United States of America.
Hum Mov Sci. 2023 Oct;91:103125. doi: 10.1016/j.humov.2023.103125. Epub 2023 Jul 27.
Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder affecting multiple functional parameters. This study examined postural stability and associated gait and neuromuscular factors in young adults with PWS.
Participants included 10 adults with PWS [7 M/3F; Body Fat % 40.61 ± 7.79]; ten normal weight (NW) adults [7 M/3F; Body Fat % 23.42 ± 7.0]; ten obese (OB) adults [7 M/3F; Body Fat % 42.40 ± 5.62]. Participants completed the Sensory Organization Test (SOT)®. Condition (C) specific and a composite equilibrium score (CES) were calculated (maximum = 100). Quadriceps strength was assessed using an isokinetic dynamometer. Three-dimensional gait analyses were completed along a 10 m walkway using a motion capture system and two force plates. A gait stability ratio (GSR) was computed from gait speed and step length (steps/m).
The PWS group had lower scores for C1, C3, C4 and CES compared to the NW (p < .039 for all) and lower scores for C4 and CES than the OB (p < .019 for both) groups, respectively. In C5 (eyes closed, sway-referenced support) and C6 (sway-referenced vision and support), 33.3% of participants with PWS fell during the first trial in both conditions (X [2] 7.436, p = .024) and (X [2] 7.436, p = .024) but no participant in the other groups fell. Those with PWS showed higher GSR than participants with NW (p = .005) and those with obesity (p = .045).
Individuals with PWS had more difficulty maintaining standing balance when relying on information from the somatosensory (C3), visual-vestibular (C4) and vestibular systems (C5, C6). A more stable walk was related to shorter steps, slower velocity and reduced peak quadriceps torque. Participation in multisensory activities that require appropriate prioritization of sensory system(s) input for controlling balance in altered sensory environments should be routinely included. In addition, exercises targeting muscular force and power should be included as part of exercise programming in PWS.
普拉德-威利综合征（PWS）是一种罕见的神经发育障碍，影响多个功能参数。本研究旨在探讨年轻成年人 PWS 患者的姿势稳定性及其相关的步态和神经肌肉因素。
参与者包括 10 名 PWS 成年人[7 名男性/3 名女性；体脂%40.61±7.79]；10 名正常体重（NW）成年人[7 名男性/3 名女性；体脂%23.42±7.0]；10 名肥胖（OB）成年人[7 名男性/3 名女性；体脂%42.40±5.62]。参与者完成了感觉组织测试（SOT）®。计算了条件（C）特定和综合平衡评分（CES）（最大值=100）。使用等速测力计评估股四头肌力量。使用运动捕捉系统和两个测力板在 10 米步行道上完成三维步态分析。从步态速度和步长（步/米）计算步态稳定性比（GSR）。
与 NW 组相比（p<.039 均），PWS 组 C1、C3、C4 和 CES 得分较低，与 OB 组相比（p<.019 均），C4 和 CES 得分较低。在 C5（闭眼，参考摆动的支撑）和 C6（参考摆动的视觉和支撑）中，33.3%的 PWS 参与者在两种情况下的第一次试验中跌倒（X[2]7.436，p=.024）和（X[2]7.436，p=.024），但其他组没有参与者跌倒。与 NW 参与者（p=.005）和肥胖参与者（p=.045）相比，PWS 参与者的 GSR 更高。
依赖于躯体感觉（C3）、视觉-前庭（C4）和前庭系统（C5、C6）信息时，PWS 个体维持站立平衡的能力更差。更稳定的步行与更短的步幅、更慢的速度和降低的峰值股四头肌扭矩有关。应常规包括需要适当优先考虑感觉系统输入以控制改变的感觉环境中的平衡的多感觉活动。此外，应将针对肌肉力量和力量的锻炼作为 PWS 锻炼计划的一部分。
