PDF(Pubmed)
Abstract：
UNASSIGNED: People with Parkinson\'s Disease (PD) often show reduced anticipatory postural adjustments (APAs) before voluntary steps, impacting their stability. The specific subphase within the APA stage contributing significantly to fall risk remains unclear.
UNASSIGNED: We analyzed center of pressure (CoP) trajectory parameters, including duration, length, and velocity, throughout gait initiation. This examination encompassed both the postural phase, referred to as anticipatory postural adjustment (APA) (APA1, APA2a, APA2b), and the subsequent locomotor phases (LOC). Participants were instructed to initiate a step and then stop (initiating a single step). Furthermore, we conducted assessments of clinical disease severity using the Unified Parkinson\'s Disease Rating Scale (UPDRS) and evaluated fall risk using Tinetti gait and balance scores during off-medication periods.
UNASSIGNED: Freezing of gait (FOG) was observed in 18 out of 110 participants during the measurement of CoP trajectories. The Ramer-Douglas-Peucker algorithm successfully identified CoP displacement trajectories in 105 participants (95.5%), while the remaining 5 cases could not be identified due to FOG. Tinetti balance and gait score showed significant associations with levodopa equivalent daily dose, UPDRS total score, disease duration, duration (s) in APA2a (s) and LOC (s), length in APA1 (cm) and APA2b (cm), mediolateral velocity in APA1 (X) (cm/s), APA2a (X) (cm/s), APA2b (X) (cm/s) and LOC (X) (cm/s), and anterior-posterior velocity in APA2a (Z) (cm/s) and APA2b (Z) (cm/s). Multiple linear regression revealed that only duration (s) in APA2a and UPDRS total score was independently associated with Tinetti gait and balance score. Further mediation analysis showed that the duration (s) in APA2a served as a mediator between UPDRS total score and Tinetti balance and gait score (Sobel test, p = 0.047).
UNASSIGNED: APA2 subphase duration mediates the link between disease severity and fall risk in PD, suggesting that longer APA2a duration may indicate reduced control during gait initiation, thereby increasing fall risk.
UNASSIGNED: We analyzed center of pressure (CoP) trajectory parameters, including duration, length, and velocity, throughout gait initiation. This examination encompassed both the postural phase, referred to as anticipatory postural adjustment (APA) (APA1, APA2a, APA2b), and the subsequent locomotor phases (LOC). Participants were instructed to initiate a step and then stop (initiating a single step). Furthermore, we conducted assessments of clinical disease severity using the Unified Parkinson\'s Disease Rating Scale (UPDRS) and evaluated fall risk using Tinetti gait and balance scores during off-medication periods.
UNASSIGNED: Freezing of gait (FOG) was observed in 18 out of 110 participants during the measurement of CoP trajectories. The Ramer-Douglas-Peucker algorithm successfully identified CoP displacement trajectories in 105 participants (95.5%), while the remaining 5 cases could not be identified due to FOG. Tinetti balance and gait score showed significant associations with levodopa equivalent daily dose, UPDRS total score, disease duration, duration (s) in APA2a (s) and LOC (s), length in APA1 (cm) and APA2b (cm), mediolateral velocity in APA1 (X) (cm/s), APA2a (X) (cm/s), APA2b (X) (cm/s) and LOC (X) (cm/s), and anterior-posterior velocity in APA2a (Z) (cm/s) and APA2b (Z) (cm/s). Multiple linear regression revealed that only duration (s) in APA2a and UPDRS total score was independently associated with Tinetti gait and balance score. Further mediation analysis showed that the duration (s) in APA2a served as a mediator between UPDRS total score and Tinetti balance and gait score (Sobel test, p = 0.047).
UNASSIGNED: APA2 subphase duration mediates the link between disease severity and fall risk in PD, suggesting that longer APA2a duration may indicate reduced control during gait initiation, thereby increasing fall risk.
摘要：
■患有帕金森病（PD）的人通常在自愿步骤之前表现出减少的预期姿势调整（APAs），影响他们的稳定性。APA阶段中对跌倒风险有重要影响的具体子阶段仍不清楚。
■我们分析了压力中心（CoP）轨迹参数，包括持续时间，长度,和速度，整个步态开始。这项检查涵盖了两个姿势阶段，称为预期姿势调整(APA)(APA1、APA2a、APA2b),和随后的运动阶段（LOC）。参与者被指示开始一个步骤，然后停止（开始一个步骤）。此外，我们使用统一帕金森病评定量表(UPDRS)对临床疾病的严重程度进行评估,并在非用药期间使用Tinetti步态和平衡评分对跌倒风险进行评估.
■在测量CoP轨迹时，在110名参与者中有18名观察到步态（FOG）冻结。Ramer-Douglas-Peucker算法成功识别了105名参与者（95.5%）的CoP位移轨迹，而其余5例由于FOG而无法识别。Tinetti平衡和步态评分显示与左旋多巴等效日剂量显著相关，UPDRS总分,疾病持续时间,APA2a（s）和LOC（s）中的持续时间，长度为APA1（cm）和APA2b（cm），APA1(X)中外侧速度(cm/s)，APA2a(X)(cm/s),APA2b(X)(cm/s)和LOC(X)(cm/s),APA2a（Z）（cm/s）和APA2b（Z）（cm/s）的前后速度。多元线性回归显示，仅APA2a和UPDRS总分的持续时间与Tinetti步态和平衡评分独立相关。进一步的中介分析表明，APA2a中的持续时间是UPDRS总分与Tinetti平衡和步态评分之间的中介（Sobel检验，p=0.047)。
■APA2子阶段持续时间介导PD中疾病严重程度与跌倒风险之间的联系，表明较长的APA2a持续时间可能表明步态启动期间控制降低，从而增加跌倒风险。
■我们分析了压力中心（CoP）轨迹参数，包括持续时间，长度,和速度，整个步态开始。这项检查涵盖了两个姿势阶段，称为预期姿势调整(APA)(APA1、APA2a、APA2b),和随后的运动阶段（LOC）。参与者被指示开始一个步骤，然后停止（开始一个步骤）。此外，我们使用统一帕金森病评定量表(UPDRS)对临床疾病的严重程度进行评估,并在非用药期间使用Tinetti步态和平衡评分对跌倒风险进行评估.
■在测量CoP轨迹时，在110名参与者中有18名观察到步态（FOG）冻结。Ramer-Douglas-Peucker算法成功识别了105名参与者（95.5%）的CoP位移轨迹，而其余5例由于FOG而无法识别。Tinetti平衡和步态评分显示与左旋多巴等效日剂量显著相关，UPDRS总分,疾病持续时间,APA2a（s）和LOC（s）中的持续时间，长度为APA1（cm）和APA2b（cm），APA1(X)中外侧速度(cm/s)，APA2a(X)(cm/s),APA2b(X)(cm/s)和LOC(X)(cm/s),APA2a（Z）（cm/s）和APA2b（Z）（cm/s）的前后速度。多元线性回归显示，仅APA2a和UPDRS总分的持续时间与Tinetti步态和平衡评分独立相关。进一步的中介分析表明，APA2a中的持续时间是UPDRS总分与Tinetti平衡和步态评分之间的中介（Sobel检验，p=0.047)。
■APA2子阶段持续时间介导PD中疾病严重程度与跌倒风险之间的联系，表明较长的APA2a持续时间可能表明步态启动期间控制降低，从而增加跌倒风险。
