服药期和停药期对帕金森病步行能力的影响:基于运动协同作用的见解

Effects of On- and Off-Medication Periods on Walking Performance in Parkinson's Disease: Insights from Movement Synergies.

作者信息

Promsri Arunee, Federolf Peter

机构信息

Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand.

Department of Sport Science, University of Innsbruck, Innsbruck, Austria.

出版信息

Digit Biomark. 2025 Jun 2;9(1):104-112. doi: 10.1159/000546733. eCollection 2025 Jan-Dec.

Abstract

INTRODUCTION

Impaired walking performance significantly impacts the quality of life in individuals with Parkinson's disease (PD). This study aimed to examine the effects of medication "on" and "off" periods on walking performance, focusing on an alternative aspect of traditional gait analysis by assessing movement components or synergies (i.e., principal movements, PMs).

METHODS

Principal component analysis was used to decompose kinematic marker data from 22 PD patients (64.1 ± 10.5 years) during self-selected speed overground walking into a set of PMs that cooperatively contribute to the locomotion task. Gait adaptation between medication periods was assessed using two PM-based variables: relative explained variance (rVAR) of the PM's position, reflecting movement structure, and root mean square (RMS) of the PM's acceleration, indicating movement acceleration magnitude and reflecting changes in force or speed.

RESULTS

The on-medication condition increased the contribution (greater rVAR) of PM, representing the swing-phase movement component ( = 0.001), and enhanced movement acceleration magnitudes (greater RMS) in PM, characterizing the single-leg support phase coupled with trunk rotation ( = 0.026).

CONCLUSION

Although medication enhances propulsion by increasing the contribution of swing-phase movement components, thereby improving forward movement and walking efficiency, it may also lead to instability during the single-leg stance phase.

摘要

引言

步行能力受损对帕金森病(PD)患者的生活质量有显著影响。本研究旨在探讨药物“开期”和“关期”对步行能力的影响,重点是通过评估运动成分或协同作用(即主要运动,PMs)来研究传统步态分析的一个替代方面。

方法

采用主成分分析将22例PD患者(64.1±10.5岁)在自选速度下地面行走时的运动学标记数据分解为一组对运动任务有协同作用的主要运动。使用基于两个主要运动的变量评估药物治疗期间的步态适应性:主要运动位置的相对解释方差(rVAR),反映运动结构;主要运动加速度的均方根(RMS),表示运动加速度大小并反映力或速度的变化。

结果

服药状态增加了代表摆动相运动成分的主要运动的贡献(更大的rVAR)( = 0.001),并增强了主要运动中的运动加速度大小(更大的RMS),其特征为单腿支撑相伴有躯干旋转( = 0.026)。

结论

虽然药物通过增加摆动相运动成分的贡献来增强推进力,从而改善向前运动和步行效率,但它也可能导致单腿站立期的不稳定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b1/12215196/6326a6382f35/dib-2025-0009-0001-546733_F01.jpg

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