Push-Off Efficacy in Parkinson’s Disease compared to healthy controls and its relationship with step length

IF 2.4 3区医学 Q3 BIOPHYSICS

Journal of biomechanics Pub Date : 2025-08-14 DOI:10.1016/j.jbiomech.2025.112912

Diego Tosatto , Daniele Bonacina , Cecilia Perin , Elisa Curti , Lorenzo Amati , Cristiano Alessandro , Daniele Piscitelli

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Abstract

The reduction of step length is one of the most common gait impairments in patients with Parkinson’s Disease (PD). However, the neuromuscular strategies associated to this gait impairment are still unclear. This study aimed to investigate the potential relationship between muscle activation and step length in PD and healthy controls.

In this observational study, we employed a linear regression model to quantify the relationship between step length and gastrocnemius medialis activation in PD and in healthy controls (HC). Muscle activity was quantified using the area under the curve (AUC) of the EMG envelopes during the push-off phase of the gait cycle, normalized to peak of activation across trials. Comparisons of time-varying EMG activation profiles and of step length between PD and HC were performed to identify potentially different neuromuscular strategies between the two groups.

A reduction of step length (mean difference [MD] = 6.22 cm; 95 % Confidence Interval [CI]: 1.05;11.40; p = 0.021), even when normalized to subject height (MD = 3.16 %; 95 %CI: 0.39;5.92; p = 0.027), was found. A modest to high correlation between step length and gastrocnemius medialis activity was found only in HC (r = 0.623; p = 0.007), while there was no correlation between these two variables in PD (r = 0.214; p = 0.294).

In PD the reduction of step length is therefore not associated with gastrocnemius medialis activity during push-off. Therefore, different mechanisms may underpin this behavior and are discussed.

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帕金森病推离疗效与健康对照及其与步长的关系

步长减少是帕金森病患者最常见的步态障碍之一。然而，与这种步态障碍相关的神经肌肉策略仍不清楚。本研究旨在探讨PD患者和健康对照者肌肉激活与步长之间的潜在关系。在这项观察性研究中，我们采用线性回归模型来量化PD和健康对照（HC）中步长与腓肠肌内侧肌激活之间的关系。在步态周期的推蹬阶段，使用肌电包膜的曲线下面积（AUC）来量化肌肉活动，并将其归一化为各试验中激活的峰值。比较PD和HC之间随时间变化的肌电图激活谱和步长，以确定两组之间潜在的不同神经肌肉策略。即使将步长归一化到受试者身高（MD = 3.16%; 95% CI: 0.39;5.92; p = 0.027），也发现步长减少（平均差[MD] = 6.22 cm； 95%置信区间[CI]: 1.05;11.40; p = 0.021）。步长与腓肠肌内侧肌活动之间有中等到高度的相关性（r = 0.623; p = 0.007），而在PD中这两个变量之间没有相关性（r = 0.214; p = 0.294）。在PD中，步长减少与推离时腓肠肌内侧肌活动无关。因此，不同的机制可能支持这种行为，并进行了讨论。

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 biomechanics 生物-工程：生物医学

CiteScore

5.10

自引率

4.20%

发文量

345

审稿时长

1 months

期刊介绍： The Journal of Biomechanics publishes reports of original and substantial findings using the principles of mechanics to explore biological problems. Analytical, as well as experimental papers may be submitted, and the journal accepts original articles, surveys and perspective articles (usually by Editorial invitation only), book reviews and letters to the Editor. The criteria for acceptance of manuscripts include excellence, novelty, significance, clarity, conciseness and interest to the readership. Papers published in the journal may cover a wide range of topics in biomechanics, including, but not limited to: -Fundamental Topics - Biomechanics of the musculoskeletal, cardiovascular, and respiratory systems, mechanics of hard and soft tissues, biofluid mechanics, mechanics of prostheses and implant-tissue interfaces, mechanics of cells. -Cardiovascular and Respiratory Biomechanics - Mechanics of blood-flow, air-flow, mechanics of the soft tissues, flow-tissue or flow-prosthesis interactions. -Cell Biomechanics - Biomechanic analyses of cells, membranes and sub-cellular structures; the relationship of the mechanical environment to cell and tissue response. -Dental Biomechanics - Design and analysis of dental tissues and prostheses, mechanics of chewing. -Functional Tissue Engineering - The role of biomechanical factors in engineered tissue replacements and regenerative medicine. -Injury Biomechanics - Mechanics of impact and trauma, dynamics of man-machine interaction. -Molecular Biomechanics - Mechanical analyses of biomolecules. -Orthopedic Biomechanics - Mechanics of fracture and fracture fixation, mechanics of implants and implant fixation, mechanics of bones and joints, wear of natural and artificial joints. -Rehabilitation Biomechanics - Analyses of gait, mechanics of prosthetics and orthotics. -Sports Biomechanics - Mechanical analyses of sports performance.