Academy of Medical Engineering and Translational Medicine, Medical School, Faculty of Medicine, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin, 300072, China.
Haihe Laboratory of Brain-computer Interaction and Human-machine Integration, No. 26 Ziyuan Road, Xiqing District, Tianjin, 300392, China.
J Neuroeng Rehabil. 2024 Sep 19;21(1):166. doi: 10.1186/s12984-024-01456-0.
The loss of gait automaticity is a key cause of motor deficits in Parkinson's disease (PD) patients, even at the early stage of the disease. Action observation training (AOT) shows promise in enhancing gait automaticity. However, effective assessment methods are lacking. We aimed to propose a novel gait normalcy index based on dual task cost (NIDTC) and evaluate its validity and responsiveness for early-stage PD rehabilitation.
Thirty early-stage PD patients were recruited and randomly assigned to the AOT or active control (CON) group. The proposed NIDTC during straight walking and turning tasks and clinical scale scores were measured before and after 12 weeks of rehabilitation. The correlations between the NIDTCs and clinical scores were analyzed with Pearson correlation coefficient analysis to evaluate the construct validity. The rehabilitative changes were assessed using repeated-measures ANOVA, while the responsiveness of NIDTC was further compared by t tests.
The turning-based NIDTC was significantly correlated with multiple clinical scales. Significant group-time interactions were observed for the turning-based NIDTC (F = 4.669, p = 0.042), BBS (F = 6.050, p = 0.022) and PDQ-39 (F = 7.772, p = 0.011) tests. The turning-based NIDTC reflected different rehabilitation effects between the AOT and CON groups, with the largest effect size (p = 0.020, Cohen's d = 0.933).
The turning-based NIDTC exhibited the highest responsiveness for identifying gait automaticity improvement by providing a comprehensive representation of motor ability during dual tasks. It has great potential as a valid measure for early-stage PD diagnosis and rehabilitation assessment. Trial registration Chinese Clinical Trial Registry: ChiCTR2300067657.
步态自动性丧失是帕金森病（PD）患者运动缺陷的一个关键原因，即使在疾病的早期阶段也是如此。动作观察训练（AOT）在增强步态自动性方面显示出前景。然而，缺乏有效的评估方法。我们旨在提出一种基于双重任务成本的新步态正常指数（NIDTC），并评估其在早期 PD 康复中的有效性和反应性。
招募了 30 名早期 PD 患者，并将其随机分配到 AOT 或主动对照组（CON）。在 12 周康复前后，测量了直走和转弯任务时的建议 NIDTC 和临床量表评分。使用 Pearson 相关系数分析来分析 NIDTC 与临床评分之间的相关性，以评估结构有效性。使用重复测量方差分析评估康复变化，并用 t 检验进一步比较 NIDTC 的反应性。
转弯任务的 NIDTC 与多个临床量表显著相关。转弯任务的 NIDTC （F = 4.669，p = 0.042）、BBS （F = 6.050，p = 0.022）和 PDQ-39 （F = 7.772，p = 0.011）测试都观察到显著的组-时间交互作用。转弯任务的 NIDTC 反映了 AOT 和 CON 组之间不同的康复效果，其效果大小最大（p = 0.020，Cohen's d = 0.933）。
转弯任务的 NIDTC 通过提供双重任务中运动能力的综合表现，表现出对识别步态自动性改善的最高反应性。它具有作为早期 PD 诊断和康复评估的有效测量手段的巨大潜力。
中国临床试验注册中心：ChiCTR2300067657。
