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[帕金森病患者步态的自动运动分析:左旋多巴和视觉刺激的影响]

[Automatic motion analysis of gait in patients with Parkinson disease: effects of levodopa and visual stimulations].

作者信息

Azulay J P, Van Den Brand C, Mestre D, Blin O, Sangla I, Pouget J, Serratrice G

机构信息

Service de Neurologie et Maladies Neuromusculaires, CHU Timone, Marseille.

出版信息

Rev Neurol (Paris). 1996 Feb;152(2):128-34.

PMID:8761620
Abstract

Gait analysis of 13 patients affected by Parkinson's disease (PD) and 7 healthy elderly volunteers was performed with a fully automatic motion analyser. The recording included stride parameters for walking velocity, stride length, stride duration and swing time. Maximal amplitudes of rotation of the hip, knee and ankle were also recorded. The analysis was performed for the PD's patients before and after L-Dopa intake. All the patients walked with and without transversal stripes on the floor. The contrasting white lines were 45 cm apart. After medication, the stride length, the velocity and the swing phase duration were significantly increased. The movements around the hip, knee and ankle joints that were initially reduced, poorly increased after L-Dopa intake. When stripes were placed on the floor, no significant changes occurred for the overall group of patients. Seven parkinsonian patients did improve with visual guidance, increasing their stride length and their speed. Some rotations of hip and knee were also influenced by stripes. This sub-group of patients was characterized by older age, a slower walking velocity, a smaller stride length and a shorter swing time. We correlated the sensitivity to visual cues to the defect of the visual contrast sensitivity that has been established in PD by several recent works. Locomotion on the transverse lines might have produced a motion perception at a rate determined by the speed of the patient. For appropriate intervals between stripes, one can hypothesise that the resulting visual stimuli belonged to a range of spatio-temporal frequencies that are decreased in patients with PD.

摘要

使用全自动运动分析仪对13名帕金森病(PD)患者和7名健康老年志愿者进行了步态分析。记录内容包括步行速度、步长、步幅持续时间和摆动时间等步幅参数。还记录了髋、膝和踝关节的最大旋转幅度。对PD患者在服用左旋多巴前后进行了分析。所有患者在有和没有地板上的横向条纹的情况下行走。对比鲜明的白线相距45厘米。服药后,步长、速度和摆动相持续时间显著增加。最初减少的髋、膝和踝关节周围的运动,在服用左旋多巴后增加不明显。当在地板上放置条纹时,整个患者组没有发生显著变化。7名帕金森病患者在视觉引导下确实有所改善,增加了步长和速度。髋和膝的一些旋转也受到条纹的影响。这一亚组患者的特点是年龄较大、步行速度较慢、步长较小和摆动时间较短。我们将对视觉线索的敏感性与最近几项研究在PD中确定的视觉对比敏感度缺陷相关联。在横向线上行走可能以患者速度确定的速率产生运动感知。对于条纹之间的适当间隔,可以假设所产生的视觉刺激属于PD患者中降低的一系列时空频率范围。

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