Turns while walking among individuals with Parkinson's disease following overground locomotor training: A pilot study

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2024-04-01 DOI:10.1016/j.clinbiomech.2024.106234

R. Jamil Pugh , Rosemary D. Higgins , Hua Min , Clinton J. Wutzke , Andrew A. Guccione

{"title":"Turns while walking among individuals with Parkinson's disease following overground locomotor training: A pilot study","authors":"R. Jamil Pugh , Rosemary D. Higgins , Hua Min , Clinton J. Wutzke , Andrew A. Guccione","doi":"10.1016/j.clinbiomech.2024.106234","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Individuals with Parkinson's disease are challenged in making turns while walking, evidenced by reduced intersegmental coordination and reduced dynamic postural stability. Although overground locomotor training previously improved ambulation among people with Parkinson's disease, its effect on walking turns remained unknown. We sought to understand the effects of overground locomotor training on walking turns among individuals with mild-Parkinson's disease.</p></div><div><h3>Methods</h3><p>Twelve participants with Parkinson's (7 Males/5 Females; Age: 68.5 ± 6.4 years) completed twenty-four sessions lasting approximately 60 min and over 12–15 weeks. Baseline and follow-up assessments included the ten-minute walk test using wearable sensors. Primary outcomes included changes to intersegmental coordination, measured by peak rotation and normalized peak rotation, and dynamic postural stability, measured by peak turn velocities in the frontal and transverse planes. Statistical analysis included one-tailed paired <em>t</em>-tests and Cohen's <em>d</em> effect sizes with α = 0.05.</p></div><div><h3>Findings</h3><p>No effects of overground locomotor training on mean peak thoracic rotation (+0.23 ± 4.24°; Cohen's <em>d</em> = 0.05; <em>P</em> = 0.45) or mean normalized peak thoracic rotation (−0.59 ± 5.52 (unitless); Cohen's <em>d</em> = 0.10; <em>P</em> = 0.45) were observed. Moderate and small effects of overground locomotor training were observed on mean peak turn velocities in the frontal (+1.59 ± 2.18°/s; Cohen's <em>d</em> = 0.43; <em>P</em> = 0.01) and transverse planes (+0.88 ± 3.18°/s; Cohen's <em>d</em> = 0.25; <em>P</em> = 0.18).</p></div><div><h3>Interpretation</h3><p>This pilot study provides preliminary evidence suggesting that individuals with mild-Parkinson's moderately improved frontal plane dynamic postural stability after overground locomotor training, likely attenuating the perturbations experienced while turning.</p><p><strong>Clinical Trial Registration</strong>: <span>NCT03864393</span><svg><path></path></svg></p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"114 ","pages":"Article 106234"},"PeriodicalIF":1.4000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Biomechanics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0268003324000664","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Individuals with Parkinson's disease are challenged in making turns while walking, evidenced by reduced intersegmental coordination and reduced dynamic postural stability. Although overground locomotor training previously improved ambulation among people with Parkinson's disease, its effect on walking turns remained unknown. We sought to understand the effects of overground locomotor training on walking turns among individuals with mild-Parkinson's disease.

Methods

Twelve participants with Parkinson's (7 Males/5 Females; Age: 68.5 ± 6.4 years) completed twenty-four sessions lasting approximately 60 min and over 12–15 weeks. Baseline and follow-up assessments included the ten-minute walk test using wearable sensors. Primary outcomes included changes to intersegmental coordination, measured by peak rotation and normalized peak rotation, and dynamic postural stability, measured by peak turn velocities in the frontal and transverse planes. Statistical analysis included one-tailed paired t-tests and Cohen's d effect sizes with α = 0.05.

Findings

No effects of overground locomotor training on mean peak thoracic rotation (+0.23 ± 4.24°; Cohen's d = 0.05; P = 0.45) or mean normalized peak thoracic rotation (−0.59 ± 5.52 (unitless); Cohen's d = 0.10; P = 0.45) were observed. Moderate and small effects of overground locomotor training were observed on mean peak turn velocities in the frontal (+1.59 ± 2.18°/s; Cohen's d = 0.43; P = 0.01) and transverse planes (+0.88 ± 3.18°/s; Cohen's d = 0.25; P = 0.18).

Interpretation

This pilot study provides preliminary evidence suggesting that individuals with mild-Parkinson's moderately improved frontal plane dynamic postural stability after overground locomotor training, likely attenuating the perturbations experienced while turning.

Clinical Trial Registration: NCT03864393

查看原文本刊更多论文

帕金森病患者在接受地面运动训练后行走时的转身：试点研究

背景帕金森病患者在行走时转弯时会遇到困难，这表现为患者的节间协调性降低和动态姿势稳定性降低。虽然地面运动训练曾改善过帕金森病患者的行走能力，但其对步行转弯的影响仍不为人知。我们试图了解地面运动训练对轻度帕金森病患者步行转弯的影响。方法12名帕金森病患者（7 名男性/5 名女性；年龄：68.5 ± 6.4 岁）在 12-15 周内完成了 24 次训练，每次持续约 60 分钟。基线和后续评估包括使用可穿戴传感器进行的十分钟步行测试。主要结果包括节间协调性的变化（通过旋转峰值和归一化旋转峰值进行测量）和动态姿势稳定性的变化（通过正面和横向平面的转弯峰值速度进行测量）。统计分析包括单尾配对 t 检验和 Cohen's d效应大小（α = 0.05）。结果表明，地面运动训练对平均胸廓旋转峰值（+0.23 ± 4.24°；Cohen's d = 0.05；P = 0.45）或平均归一化胸廓旋转峰值（-0.59 ± 5.52（无单位）；Cohen's d = 0.10；P = 0.45）没有影响。观察到地面运动训练对额面（+1.59 ± 2.18°/s；Cohen's d = 0.43；P = 0.01）和横向（+0.88 ± 3.18°/s；Cohen's d = 0.25；P = 0.18）的平均峰值转弯速度有中等和较小的影响。释义这项试验性研究提供了初步证据，表明轻度帕金森病患者在接受地面运动训练后，额面动态姿势稳定性得到了适度改善，很可能减轻了转弯时的扰动：NCT03864393

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.