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帕金森病患者的楼梯行走动力学特征及双重任务的影响

Characterizing Stair Ambulation Kinetics and the Effects of Dual Tasking in Parkinson's Disease.

作者信息

Jones Sumner V, Waltz Colin, Zimmerman Eric, Miller Koop Mandy, Hastilow Karissa, Alberts Jay L

机构信息

Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA.

Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA.

出版信息

J Clin Med. 2025 Aug 18;14(16):5830. doi: 10.3390/jcm14165830.

Abstract

: Stair ambulation is a complex motor task that presents a substantial fall risk for people with Parkinson's disease (PwPD) who often have postural instability and gait difficulty (PIGD) and experience unpredictable freezing of gait (FOG) episodes. While dual-task (DT) interference during level walking is well-documented, its impact on stair ambulation, an everyday, high-risk activity, remains poorly understood. : The aim of this study was to quantify the impact of dual tasking on patterns of motor control during stair ambulation using kinetic data from The Stair Ambulation and Functional Evaluation of Gait (Safe-Gait) system. : Seventeen individuals with Parkinson's disease (PD) completed three single-task (ST) and three dual-task (DT) trials on the Safe-Gait system, which sampled kinetic data via embedded force plates during stair ascent and descent. The force plate data were used to quantify step time, braking and propulsive impulses, and center of pressure (CoP) displacement and sway speed to assess DT effects on stair ambulation kinetics. : Dual-task conditions led to significant increases in step time ( < 0.001), braking impulse ( < 0.01), anteroposterior center of pressure (CoP) range ( < 0.05), and a decrease in mediolateral CoP speed ( < 0.01). : Dual tasking during stair ambulation altered gait kinetics in PwPD, evidenced by slower, less stable movement patterns. These findings highlight the impact of cognitive motor DT interference on functional mobility and support the use of instrumented stair assessments to guide therapeutic care and fall risk interventions.

摘要

楼梯行走是一项复杂的运动任务,对于帕金森病患者(PwPD)来说存在很大的跌倒风险,他们通常有姿势不稳和步态困难(PIGD),并会经历不可预测的步态冻结(FOG)发作。虽然在平地行走时的双任务(DT)干扰已有充分记录,但它对楼梯行走这种日常高风险活动的影响仍知之甚少。

本研究的目的是使用来自楼梯行走与步态功能评估(Safe-Gait)系统的动力学数据,量化双任务对楼梯行走过程中运动控制模式的影响。

17名帕金森病(PD)患者在Safe-Gait系统上完成了三项单任务(ST)和三项双任务(DT)试验,该系统在楼梯上升和下降过程中通过嵌入式测力板采集动力学数据。测力板数据用于量化步长、制动和推进冲量,以及压力中心(CoP)位移和摆动速度,以评估双任务对楼梯行走动力学的影响。

双任务条件导致步长显著增加(<0.001)、制动冲量增加(<0.01)、前后压力中心(CoP)范围增加(<0.05),以及左右CoP速度降低(<0.01)。

楼梯行走时的双任务改变了PwPD的步态动力学,表现为运动模式更慢、更不稳定。这些发现突出了认知运动双任务干扰对功能活动能力的影响,并支持使用仪器化的楼梯评估来指导治疗护理和跌倒风险干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dba/12386894/f80deb01389b/jcm-14-05830-g001.jpg

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