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背景:许多特定疾病的表现,如肌肉无力、肌肉僵硬、不同的姿态策略和姿态反射的变化,已被证明能导致帕金森病患者姿势不稳且增加跌倒风险。近年来,受动力系统视角对运动控制和协调的研究所启发,相关分析技术已被用于检查帕金森病人姿态控制水平下降的动力学和站立不稳的机制。方法:用一种基于小波分析的技术确定在轻度帕金森病患者(n=10)以及年龄相匹配的对照组(n=10)前后方向姿势摇晃的极限环振荡。受试者需站在硬质泡沫塑料表面并完成双重任务(说话)。结果:两组间压力中心的均方根(RMS)无显著差异。10名帕金森病受试者中,有3名在泡沫表面出现了极限环振荡,而对照组则没有。用一个倒置的双足钟摆模型证明极限环振荡的发生源于帕金森病的某一特定变化,即神经肌肉反馈时间延迟。结论:总体而言,极限环振荡分析和数学模型可捕捉到轻度帕金森病人细微的站立不稳定性。上述发现有助于深入探索帕金森病患者的姿势不稳定机制提供可能。
BACKGROUND: The manifestation of many specific diseases, such as muscle weakness, muscle stiffness, different posture strategies and changes in posture reflexes, has been shown to lead to unstable posture and increased risk of falls in Parkinson’s disease patients. In recent years, inspired by the research on motor control and coordination from the viewpoint of motor system, the relevant analysis techniques have been used to examine the kinetics and instability mechanism of the decline of posture control in Parkinson’s patients. METHODS: A wavelet-based technique was used to determine the limit ring oscillations in the frontal and posterior direction of mild Parkinson’s disease (n = 10) and age-matched controls (n = 10). Subjects were required to stand on the surface of a rigid foam and perform dual tasks (speaking). Results: There was no significant difference in root mean square (RMS) pressure center between the two groups. Three out of 10 Parkinson’s disease subjects experienced ring oscillation on the foam surface, but none in the control group. Using an inverted biped pendulum model, it is shown that the occurrence of limit-ring oscillations results from a specific change in Parkinson’s disease, namely the time delay of neuromuscular feedback. CONCLUSIONS: In general, LIMS and mathematical models capture subtle standing instability in patients with mild Parkinson’s disease. These findings help to further explore the mechanism of postural instability in patients with Parkinson’s disease may provide.