Ghani Halimatul Abd, Alghwiri Alia A, Hisham Hafifi, Manaf Haidzir
Physiotherapy Program, Institut Latihan Kementerian Kesihatan Malaysia, Johor, Malaysia.
Department of Physiotherapy, Faculty of Allied Medical Sciences, Applied Science Private University, Amman, Jordan.
Ann Rehabil Med. 2023 Aug;47(4):282-290. doi: 10.5535/arm.23067. Epub 2023 Aug 9.
To determine the effects of lower limb muscle fatigue on spatiotemporal gait parameters and turning difficulty characteristics during the extended Timed Up and Go (extended TUG) test in individuals with different severity stages of Parkinson's disease (PD).
Forty individuals with PD, classified as Hoehn and Yahr (H&Y) stages 2 and 3 participated in this pre- and post-experimental study design. The participants performed a continuous sit-to-stand task from a chair based on 30 cycles/min set-up to induce lower limb muscle fatigue. They performed extended TUG test immediately before and after completing the fatigue protocol. Spatiotemporal gait parameters and turning difficulty characteristics were recorded using two GoPro® Hero 4 Silver cameras. Data were subjected to a repeated-measure ANOVA.
Individuals with PD experience significant changes in spatiotemporal gait parameters, specifically stride velocity and length, under conditions of lower limb muscle fatigue (p=0.001). These changes were more pronounced in individuals with PD in the H&Y stage 3 group. Additionally, both PD groups exhibited difficulty with turning, requiring more than five steps to complete a 180° turn and taking more than 3 seconds to accomplish it.
These findings highlight the impact of muscle fatigue on gait performance in PD and suggest that individuals in later stages of the disease may be particularly affected. Further research is needed to explore interventions that can mitigate these gait impairments and improve mobility in individuals with PD.
确定帕金森病（PD）不同严重程度阶段的个体在延长的定时起立行走测试（extended TUG）中，下肢肌肉疲劳对时空步态参数和转身困难特征的影响。
40名被分类为Hoehn和Yahr（H&Y）2期和3期的PD患者参与了这项实验前后研究设计。参与者以每分钟30次的频率从椅子上进行连续的坐立任务，以诱发下肢肌肉疲劳。他们在完成疲劳方案前后立即进行延长的TUG测试。使用两台GoPro® Hero 4 Silver相机记录时空步态参数和转身困难特征。数据进行重复测量方差分析。
PD患者在下肢肌肉疲劳的情况下，时空步态参数，特别是步速和步长，会发生显著变化（p = 0.001）。这些变化在H&Y 3期组的PD患者中更为明显。此外，两个PD组在转身方面都存在困难，完成180°转身需要超过五步，且耗时超过3秒。
这些发现突出了肌肉疲劳对PD患者步态表现的影响，并表明疾病后期的个体可能受到特别影响。需要进一步研究以探索能够减轻这些步态障碍并改善PD患者移动性的干预措施。
