PDF(Pubmed)
Abstract：
BACKGROUND: The laterality of motor symptoms is considered a key feature of Parkinson\'s disease (PD). Here, we investigated whether gait and turning asymmetry coincided with symptom laterality as determined by the MDS-UPRDS part III and whether it was increased compared to healthy controls (HC).
METHODS: We analyzed the asymmetry of gait and turning with and without a cognitive dual task (DT) using motion capture systems and wearable sensors in 97 PD patients mostly from Hoehn & Yahr stage II and III and 36 age-matched HC. We also assessed motor symptom asymmetry using the bilateral sub-items of the MDS-UPDRS-III. Finally, we examined the strength of the association between gait asymmetry and symptom laterality.
RESULTS: Participants with PD had increased gait but not more turning asymmetry compared to HC (p < 0.05). Only 53.7% of patients had a shorter step length on the more affected body side as determined by the MDS-UPDRS-III. Also, 54% took more time and 29% more steps during turns toward the more affected side. The degree of asymmetry in the different domains did not correlate with each other and was not influenced by DT-load.
CONCLUSIONS: We found a striking mismatch between the side and the degree of asymmetry in different motor domains, i.e., in gait, turning, and distal symptom severity in individuals with PD. We speculate that motor execution in different body parts relies on different neural control mechanisms. Our findings warrant further investigation to understand the complexity of gait asymmetry in PD.
METHODS: We analyzed the asymmetry of gait and turning with and without a cognitive dual task (DT) using motion capture systems and wearable sensors in 97 PD patients mostly from Hoehn & Yahr stage II and III and 36 age-matched HC. We also assessed motor symptom asymmetry using the bilateral sub-items of the MDS-UPDRS-III. Finally, we examined the strength of the association between gait asymmetry and symptom laterality.
RESULTS: Participants with PD had increased gait but not more turning asymmetry compared to HC (p < 0.05). Only 53.7% of patients had a shorter step length on the more affected body side as determined by the MDS-UPDRS-III. Also, 54% took more time and 29% more steps during turns toward the more affected side. The degree of asymmetry in the different domains did not correlate with each other and was not influenced by DT-load.
CONCLUSIONS: We found a striking mismatch between the side and the degree of asymmetry in different motor domains, i.e., in gait, turning, and distal symptom severity in individuals with PD. We speculate that motor execution in different body parts relies on different neural control mechanisms. Our findings warrant further investigation to understand the complexity of gait asymmetry in PD.
摘要：
背景：运动症状的偏侧性被认为是帕金森病（PD）的关键特征。这里,我们调查了由MDS-UPRDS第III部分确定的步态和转弯不对称是否与症状偏侧相一致,以及与健康对照组(HC)相比是否增加.
方法：我们使用运动捕捉系统和可穿戴传感器，在97名PD患者中，主要来自Hoehn＆YahrII期和III期，以及36名年龄匹配的HC，分析了有或没有认知双重任务（DT）的步态和转弯的不对称性。我们还使用MDS-UPDRS-III的双侧子项目评估了运动症状的不对称性。最后,我们研究了步态不对称性和症状偏侧性之间的关联强度.
结果：与HC相比，PD参与者的步态增加，但转向不对称性增加（p<0.05）。如MDS-UPDRS-III所确定的，只有53.7％的患者在更受影响的身体一侧的步长较短。此外，54%的人在转向更受影响的一侧时花费了更多的时间和29%的步骤。不同域中的不对称程度彼此不相关，并且不受DT负载的影响。
结论：我们发现不同运动域的侧面和不对称程度之间存在惊人的不匹配，即，在步态中，转动,以及PD患者的远端症状严重程度。我们推测，不同身体部位的运动执行依赖于不同的神经控制机制。我们的发现值得进一步研究，以了解PD中步态不对称的复杂性。
方法：我们使用运动捕捉系统和可穿戴传感器，在97名PD患者中，主要来自Hoehn＆YahrII期和III期，以及36名年龄匹配的HC，分析了有或没有认知双重任务（DT）的步态和转弯的不对称性。我们还使用MDS-UPDRS-III的双侧子项目评估了运动症状的不对称性。最后,我们研究了步态不对称性和症状偏侧性之间的关联强度.
结果：与HC相比，PD参与者的步态增加，但转向不对称性增加（p<0.05）。如MDS-UPDRS-III所确定的，只有53.7％的患者在更受影响的身体一侧的步长较短。此外，54%的人在转向更受影响的一侧时花费了更多的时间和29%的步骤。不同域中的不对称程度彼此不相关，并且不受DT负载的影响。
结论：我们发现不同运动域的侧面和不对称程度之间存在惊人的不匹配，即，在步态中，转动,以及PD患者的远端症状严重程度。我们推测，不同身体部位的运动执行依赖于不同的神经控制机制。我们的发现值得进一步研究，以了解PD中步态不对称的复杂性。
