PDF(Pubmed)
Abstract：
BACKGROUND: How the joints exactly move and interact and how this reflects PD-related gait abnormalities and the response to dopaminergic treatment is poorly understood. A detailed understanding of these kinematics can inform clinical management and treatment decisions. The aim of the study was to investigate the influence of different gait speeds and medication on/off conditions on inter-joint coordination, as well as kinematic differences throughout the whole gait cycle in well characterized pwPD.
METHODS: 29 controls and 29 PD patients during medication on, 8 of them also during medication off walked a straight walking path in slow, preferred and fast walking speeds. Gait data was collected using optical motion capture system. Kinematics of the hip and knee and coordinated hip-knee kinematics were evaluated using Statistical Parametric Mapping (SPM) and cyclograms (angle-angle plots). Values derived from cyclograms were compared using repeated-measures ANOVA for within group, and ttest for between group comparisons.
RESULTS: PD gait differed from controls mainly by lower knee range of motion (ROM). Adaptation to gait speed in PD was mainly achieved by increasing hip ROM. Regularity of gait was worse in PD but only during preferred speed. The ratios of different speed cyclograms were smaller in the PD groups. SPM analyses revealed that PD participants had smaller hip and knee angles during the swing phase, and PD participants reached peak hip flexion later than controls. Withdrawal of medication showed an exacerbation of only a few parameters.
CONCLUSIONS: Our findings demonstrate the potential of granular kinematic analyses, including > 1 joint, for disease and treatment monitoring in PD. Our approach can be extended to further mobility-limiting conditions and other joint combinations.
BACKGROUND: The study is registered in the German Clinical Trials Register (DRKS00022998, registered on 04 Sep 2020).
METHODS: 29 controls and 29 PD patients during medication on, 8 of them also during medication off walked a straight walking path in slow, preferred and fast walking speeds. Gait data was collected using optical motion capture system. Kinematics of the hip and knee and coordinated hip-knee kinematics were evaluated using Statistical Parametric Mapping (SPM) and cyclograms (angle-angle plots). Values derived from cyclograms were compared using repeated-measures ANOVA for within group, and ttest for between group comparisons.
RESULTS: PD gait differed from controls mainly by lower knee range of motion (ROM). Adaptation to gait speed in PD was mainly achieved by increasing hip ROM. Regularity of gait was worse in PD but only during preferred speed. The ratios of different speed cyclograms were smaller in the PD groups. SPM analyses revealed that PD participants had smaller hip and knee angles during the swing phase, and PD participants reached peak hip flexion later than controls. Withdrawal of medication showed an exacerbation of only a few parameters.
CONCLUSIONS: Our findings demonstrate the potential of granular kinematic analyses, including > 1 joint, for disease and treatment monitoring in PD. Our approach can be extended to further mobility-limiting conditions and other joint combinations.
BACKGROUND: The study is registered in the German Clinical Trials Register (DRKS00022998, registered on 04 Sep 2020).
摘要：
背景：关节如何精确移动和相互作用，以及这如何反映PD相关的步态异常和对多巴胺能治疗的反应，人们知之甚少。对这些运动学的详细了解可以为临床管理和治疗决策提供信息。该研究的目的是调查不同步态速度和药物开/关条件对关节间协调的影响，以及整个步态周期中的运动学差异特征良好的pwPD。
方法：29名对照组和29名PD患者在用药期间，8他们也在服药期间走了一条笔直的小路，首选和快速步行速度。使用光学运动捕获系统收集步态数据。使用统计参数图（SPM）和百科全书（角度-角度图）评估了髋关节和膝关节的运动学以及协调的髋-膝关节运动学。使用重复测量的ANOVA比较了来自百科全书的值，和ttest用于组间比较。
结果：PD步态与对照组的不同之处主要在于较低的膝关节运动范围（ROM）。PD对步态速度的适应主要是通过增加髋关节ROM来实现的。PD的步态规律性较差，但仅在首选速度下。PD组不同速度环谱的比值较小。SPM分析显示，PD参与者在摆动阶段髋部和膝部角度较小，PD参与者比对照组晚达到髋关节屈曲峰值。停药显示只有几个参数恶化。
结论：我们的研究结果证明了颗粒运动学分析的潜力，包括>1个接头，用于PD的疾病和治疗监测。我们的方法可以扩展到进一步的移动性限制条件和其他联合组合。
背景：该研究已在德国临床试验注册（DRKS00022998，于2020年9月4日注册）中注册。
方法：29名对照组和29名PD患者在用药期间，8他们也在服药期间走了一条笔直的小路，首选和快速步行速度。使用光学运动捕获系统收集步态数据。使用统计参数图（SPM）和百科全书（角度-角度图）评估了髋关节和膝关节的运动学以及协调的髋-膝关节运动学。使用重复测量的ANOVA比较了来自百科全书的值，和ttest用于组间比较。
结果：PD步态与对照组的不同之处主要在于较低的膝关节运动范围（ROM）。PD对步态速度的适应主要是通过增加髋关节ROM来实现的。PD的步态规律性较差，但仅在首选速度下。PD组不同速度环谱的比值较小。SPM分析显示，PD参与者在摆动阶段髋部和膝部角度较小，PD参与者比对照组晚达到髋关节屈曲峰值。停药显示只有几个参数恶化。
结论：我们的研究结果证明了颗粒运动学分析的潜力，包括>1个接头，用于PD的疾病和治疗监测。我们的方法可以扩展到进一步的移动性限制条件和其他联合组合。
背景：该研究已在德国临床试验注册（DRKS00022998，于2020年9月4日注册）中注册。
