Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, USA.
Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.
J Biomech. 2024 Apr;167:112073. doi: 10.1016/j.jbiomech.2024.112073. Epub 2024 Apr 3.
Persons with Parkinson's disease experience gait alterations, such as reduced step length. Gait dysfunction is a significant research priority as the current treatments targeting gait impairment are limited. This study aimed to investigate the effects of visual biofeedback on propulsive force during treadmill walking in persons with Parkinson's. Sixteen ambulatory persons with Parkinson's participated in the study. They received real-time biofeedback of anterior ground reaction force during treadmill walking at a constant speed. Peak propulsive force values were measured and normalized to body weight. Spatiotemporal parameters were also assessed, including stride length and double support percent. Persons with Parkinson's significantly increased peak propulsive force during biofeedback compared to baseline (p <.0001, Cohen's dz = 1.69). Variability in peak anterior ground reaction force decreased across repeated trials (p <.0001, dz = 1.51). While spatiotemporal parameters did not show significant changes individually, stride length and double support percent improved marginally during biofeedback trials. Persons with Parkinson's can increase propulsive force with visual biofeedback, suggesting the presence of a propulsive reserve. Though stride length did not significantly change, clinically meaningful improvements were observed. Targeting push-off force through visual biofeedback may offer a potential rehabilitation technique to enhance gait performance in Persons with Parkinson's. Future studies could explore the long-term efficacy of this intervention and investigate additional strategies to improve gait in Parkinson's disease.
帕金森病患者会出现步态改变，例如步长减小。步态障碍是一个重要的研究重点，因为目前针对步态障碍的治疗方法有限。本研究旨在探讨视觉生物反馈对帕金森病患者在跑步机上行走时推进力的影响。16 名有步行能力的帕金森病患者参加了这项研究。他们在跑步机上以恒定速度行走时接受了前向地面反力的实时生物反馈。测量了峰值推进力值，并将其归一化为体重。还评估了时空参数，包括步长和双支撑百分比。与基线相比，帕金森病患者在生物反馈时峰值推进力显著增加（p<.0001，Cohen's dz=1.69）。在重复试验中，前向地面反力峰值的变异性降低（p<.0001，dz=1.51）。虽然时空参数单独没有显示出显著变化，但在生物反馈试验中步长和双支撑百分比略有改善。帕金森病患者可以通过视觉生物反馈增加推进力，表明存在推进储备。虽然步长没有显著变化，但观察到了有临床意义的改善。通过视觉生物反馈来靶向蹬离力可能为增强帕金森病患者的步态表现提供一种潜在的康复技术。未来的研究可以探索这种干预的长期效果，并研究改善帕金森病步态的其他策略。
