帕金森病临床亚型的步态特征差异

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2025.106445

Sidney T. Baudendistel , Kerri S. Rawson , Christina N. Lessov-Schlaggar , Baijayanta Maiti , Paul T. Kotzbauer , Joel S. Perlmutter , Gammon M. Earhart , Meghan C. Campbell

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引用次数: 0

摘要

背景：帕金森病的临床亚型包括非运动表现可能比仅基于运动表现的亚型更有益。纳入步态指标可能有助于确定康复目标，并有可能预测帕金森病患者非运动症状的发展。这项研究的目的是表征步态差异在建立多域亚型。方法“仅限运动”、“精神病学”；“运动”和“认知”通过运动、认知和精神评估建立运动临床亚型。在“关闭”药物状态下评估行走。多变量方差分析确定了不同临床亚型的步态域差异。研究结果：与“精神病”亚型相比，“运动型”亚型表现出最快的速度、最长的步长和最小的时间变化（摇摆、步长、站姿）；“运动”和“认知”电动机”亚型。不同亚型的站立时间存在差异；”精神,“运动”亚型站立时间最长，其次是“认知”亚型；Motor”，然后是“Motor only”。精神病学&；“运动”组与“认知”组存在不同的不对称性。“运动”亚型，如“精神病学”；“运动型”的孩子在受影响较小的一侧行走的步子更长，而“认知型”的孩子则行走的步子更长。“运动”亚型则表现出相反的模式。在摆动时间、步速变异性、步长变异性、宽度测量或其他不对称测量方面没有观察到差异。解释：认知和精神亚型的步态表现比“仅运动”组差。站立时间和步长不对称在精神亚型和认知亚型之间存在差异，表明步态缺陷可能与非运动表现的不同方面有关。步态特征可以帮助临床医生区分非运动亚型，指导个性化治疗。

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Differential gait features across Parkinson's disease clinical subtypes

Background

Clinical subtypes in Parkinson's disease including non-motor manifestations may be more beneficial than subtypes based upon motor manifestations alone. Inclusion of gait metrics may help identity targets for rehabilitation and potentially predict development of non-motor symptoms for individuals with Parkinson's disease. This study aims to characterize gait differences across established multi-domain subtypes.

Methods

“Motor Only”, “Psychiatric & Motor” and “Cognitive & Motor” clinical subtypes were established through motor, cognitive, and psychiatric assessment. Walking was assessed in the “OFF” medication state. Multivariate analysis of variance identified differences in gait domains across clinical subtypes.

Findings

The “Motor Only” subtype exhibited the fastest velocity, longest step length, and least timing variability (swing, step, stance), compared to “Psychiatric & Motor” and “Cognitive & Motor” subtypes. Stance time differed across subtypes; “Psychiatric & Motor” subtype had the longest stance time, followed by “Cognitive & Motor”, then “Motor only”. The “Psychiatric & Motor” group had different asymmetry from the “Cognitive & Motor” subtype, as “Psychiatric & Motor” walked with longer steps on their less-affected side while the “Cognitive & Motor” subtype displayed the opposite pattern. No differences were observed for swing time, step velocity variability, step length variability, width measures, or other asymmetry measures.

Interpretation

Cognitive and Psychiatric subtypes displayed worse gait performance than the “Motor only” group. Stance time and step length asymmetry were different between Psychiatric and Cognitive subtypes, indicating gait deficits may be related to distinct aspects of non-motor manifestations. Gait signatures may help clinicians distinguish between non-motor subtypes, guiding personalized treatment.

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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.