Split-Belt Adaptation and Savings in People With Parkinson Disease.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neurologic Physical Therapy Pub Date : 2022-10-01 Epub Date: 2022-08-17 DOI:10.1097/NPT.0000000000000411

Elizabeth D Thompson, Darcy S Reisman

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引用次数: 0

Abstract

Background and purpose: Upper extremity studies suggest that implicit adaptation is less impaired than explicit learning in persons with Parkinson disease (PD). Little work has explored implicit locomotor adaptation and savings in this population, yet implicit locomotor learning is critical for everyday function. This cross-sectional study examined adaptation and savings in individuals with PD during split-belt treadmill walking.

Methods: Fourteen participants completed the following treadmill protocol: Baseline (6 minutes belts tied), Adaptation (10 minutes split), Washout (10 minutes tied), and Readaptation (10 minutes split). Step length and step symmetry index (SSI) were calculated to determine magnitude and rate of adaptation and savings. Rate was calculated as strides to reach SSI plateau during Adaptation and Readaptation.

Results: During Early Adaptation and Early Readaptation, SSI was perturbed from Baseline ( P < 0.001 and P = 0.002, respectively). Less perturbation in Early Readaptation ( P < 0.001) demonstrated savings. In Late Adaptation and Late Readaptation, participants returned to Baseline symmetry ( P = 0.026 and P = 0.022, respectively, with adjusted level of significance = 0.007). Adaptation was also seen in reverse asymmetry observed in Early Washout ( P = 0.003 vs Baseline). Readaptation rate was faster than in Adaptation ( P = 0.015), demonstrating savings.

Discussion and conclusions: Individuals with PD showed locomotor adaptation in an implicit sensorimotor adaptation task. They also demonstrated savings, with less perturbation and faster adaptation during the second split-belt exposure. However, performance was variable; some individuals showed minimal adaptation. Variations in learning, savings, and clinical presentation highlight the need to further explore characteristics of individuals with PD most likely to benefit from adaptation-based locomotor training.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A395 ).

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帕金森病患者的分流带适应和储蓄。

背景和目的：上肢研究表明，帕金森病患者的内隐适应比外显学习受损更小。很少有研究探讨这一人群的内隐运动适应和储蓄，但内隐运动学习对日常功能至关重要。这项横断面研究考察了帕金森病患者在分带跑步机行走过程中的适应和节省。方法：14名参与者完成了以下跑步机方案：基线（6分钟系好安全带）、适应（10分钟分开）、冲洗（10分钟系好）和重新适应（10分分开）。计算步长和步长对称指数（SSI），以确定适应和节省的幅度和速率。速率计算为适应和重新适应期间达到SSI平台的步幅。结果：在早期适应和早期重新适应期间，SSI从基线开始受到干扰（分别为P<0.001和P=0.002）。早期再适应的干扰较小（P＜0.001），显示节省。在后期适应和后期再适应中，参与者恢复到基线对称性（分别为P=0.026和P=0.022，调整后的显著性水平=0.007）。在早期冲刷中观察到的反向不对称性中也出现了适应（与基线相比P=0.003）。再适应率高于适应期（P=0.015），显示出节约。讨论和结论：帕金森病患者在内隐感觉运动适应任务中表现出运动适应。它们还证明了在第二次分带曝光期间的节省，扰动更小，适应更快。然而，业绩参差不齐；一些个体表现出最小的适应能力。学习、储蓄和临床表现的变化突出了进一步探索PD患者最有可能从基于适应的运动训练中受益的特征的必要性。视频摘要可从作者那里获得更多见解（请参阅视频，补充数字内容1，可在：http://links.lww.com/JNPT/A395）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurologic Physical Therapy CLINICAL NEUROLOGY-REHABILITATION

CiteScore

5.70

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Neurologic Physical Therapy (JNPT) is an indexed resource for dissemination of research-based evidence related to neurologic physical therapy intervention. High standards of quality are maintained through a rigorous, double-blinded, peer-review process and adherence to standards recommended by the International Committee of Medical Journal Editors. With an international editorial board made up of preeminent researchers and clinicians, JNPT publishes articles of global relevance for examination, evaluation, prognosis, intervention, and outcomes for individuals with movement deficits due to neurologic conditions. Through systematic reviews, research articles, case studies, and clinical perspectives, JNPT promotes the integration of evidence into theory, education, research, and practice of neurologic physical therapy, spanning the continuum from pathophysiology to societal participation.