De Waele Ségolène, Hallemans Ann, Maréchal Emke, Cras Patrick, Crosiers David
Translational Neurosciences, Born-Bunge Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Antwerp University Hospital, Department of Neurology, Antwerp, Belgium.
Heliyon. 2023 Dec 20;10(1):e23740. doi: 10.1016/j.heliyon.2023.e23740. eCollection 2024 Jan 15.
Gait initiation is preceded by three anticipatory postural adjustment (APA) phases. In Parkinson's disease (PD) generated force, displacement and timing during APA differ from healthy controls. APA might be influenced by disease status, weight or emotion. It is unknown how motor severity, disease duration or presence of apathy influences APA timing and displacement.
We included 99 people with PD and 50 healthy controls (HC) to perform five gait initiation trials following an auditory cue. Force plates measured timing and center of pressure (CoP) displacement during APA phases.
Time to gait initiation (tGI) was higher in the PD group (p < 0.001, t = 2.74, 95%CI (0.008, 0.066)). The first two APA phases (APA1 and APA2a) lasted longer in PD (respectively p < 0.001, t = 3.87, 95%CI (0.091, 0.28) and p < 0.001, t = 4.1, 95%CI (0.031, 0.091)). Mean CoP displacement, variability in timing and displacement did not differ. A multiple regression model was used to determine if clinical variables were related to gait initiation parameters. tGI was predicted by age (p < 0.001) and weight (p = 0.005). The duration of APA1 was predicted by weight (p = 0.006) and APA2a by age (p < 0.001). Variability in duration of the locomotor phase (LOC) was predicted by age (p < 0.001).
tGI and initial APA phases are longer in PD than in HC. There are no significant differences in variability of timing or displacement between the two groups. Gait initiation parameters are independent of disease duration, motor severity, medication usage or apathy in PD. Our findings suggest that cueing does not speed up gait initiation but reduces variability.
步态起始之前有三个预期姿势调整（APA）阶段。在帕金森病（PD）中，APA期间产生的力量、位移和时间与健康对照不同。APA可能受疾病状态、体重或情绪影响。目前尚不清楚运动严重程度、疾病持续时间或冷漠的存在如何影响APA的时间和位移。
我们纳入了99名帕金森病患者和50名健康对照（HC），在听觉提示后进行五次步态起始试验。测力板测量了APA阶段的时间和压力中心（CoP）位移。
PD组的步态起始时间（tGI）更高（p < 0.001，t = 2.74，95%CI（0.008，0.066））。PD组的前两个APA阶段（APA1和APA2a）持续时间更长（分别为p < 0.001，t = 3.87，95%CI（0.091，0.28）和p < 0.001，t = 4.1，95%CI（0.031，0.091））。平均CoP位移、时间和位移的变异性没有差异。使用多元回归模型来确定临床变量是否与步态起始参数相关。tGI由年龄（p < 0.001）和体重（p = 0.005）预测。APA1的持续时间由体重（p = 0.006）预测，APA2a由年龄（p < 0.001）预测。运动阶段（LOC）持续时间的变异性由年龄（p < 0.001）预测。
PD患者的tGI和初始APA阶段比HC患者更长。两组之间时间或位移的变异性没有显著差异。步态起始参数与PD的疾病持续时间、运动严重程度、药物使用或冷漠无关。我们的研究结果表明，提示不会加快步态起始，但会降低变异性。
