{"title":"踝关节背屈训练对帕金森病患者步态起始期预期体位调整的影响。","authors":"Atsushi Nagai , Kohei Marumoto , Kota Ohata , Shoma Takasaki , Hideki Moriyama","doi":"10.1016/j.gaitpost.2024.12.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Freezing of gait (FOG) during gait initiation in patients with Parkinson's disease (PD) is associated with anticipatory postural adjustments (APAs) with diminishing amplitude, leading to a risk of falls. Assistance with ankle dorsiflexion function by external devices improve APAs during gait initiation, however, the effect of training to improve ankle dorsiflexion function on APAs during gait initiation is unclear.</div></div><div><h3>Research question</h3><div>Does ankle dorsiflexion training improve APAs and FOG during gait initiation in patients with PD?</div></div><div><h3>Method</h3><div>This 4-week prospective controlled trial included 30 patients with PD, who were divided into two groups: the control group, which received only conventional inpatient rehabilitation, and the intervention group, which received ankle dorsiflexion training in addition to inpatient rehabilitation. Ankle dorsiflexion training consisted of strengthening ankle dorsiflexion muscles and transferring weight backwards while standing. The primary outcomes were displacement of the center of pressure (COP) and electromyography of the tibialis anterior muscle during gait initiation as APAs. The secondary outcome was the New freezing of gait questionnaire (NFOGQ) to determine the severity of FOG. We analyzed differences in treatment effects between groups and within groups.</div></div><div><h3>Result</h3><div>In the intervention group, the anteroposterior component of COP displacement and muscle activity of the tibialis anterior muscle increased significantly and NFOGQ decreased after the intervention. After intervention, the anteroposterior component of COP displacement showed a significant intervention effect.</div></div><div><h3>Significance</h3><div>Ankle dorsiflexion training for patients with PD improves APAs and FOG during gait initiation and may reduce the risk of falls.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"117 ","pages":"Pages 109-114"},"PeriodicalIF":2.2000,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of ankle dorsiflexion training on anticipatory postural adjustments during gait initiation in patients with Parkinson’s disease\",\"authors\":\"Atsushi Nagai , Kohei Marumoto , Kota Ohata , Shoma Takasaki , Hideki Moriyama\",\"doi\":\"10.1016/j.gaitpost.2024.12.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Freezing of gait (FOG) during gait initiation in patients with Parkinson's disease (PD) is associated with anticipatory postural adjustments (APAs) with diminishing amplitude, leading to a risk of falls. Assistance with ankle dorsiflexion function by external devices improve APAs during gait initiation, however, the effect of training to improve ankle dorsiflexion function on APAs during gait initiation is unclear.</div></div><div><h3>Research question</h3><div>Does ankle dorsiflexion training improve APAs and FOG during gait initiation in patients with PD?</div></div><div><h3>Method</h3><div>This 4-week prospective controlled trial included 30 patients with PD, who were divided into two groups: the control group, which received only conventional inpatient rehabilitation, and the intervention group, which received ankle dorsiflexion training in addition to inpatient rehabilitation. Ankle dorsiflexion training consisted of strengthening ankle dorsiflexion muscles and transferring weight backwards while standing. The primary outcomes were displacement of the center of pressure (COP) and electromyography of the tibialis anterior muscle during gait initiation as APAs. The secondary outcome was the New freezing of gait questionnaire (NFOGQ) to determine the severity of FOG. We analyzed differences in treatment effects between groups and within groups.</div></div><div><h3>Result</h3><div>In the intervention group, the anteroposterior component of COP displacement and muscle activity of the tibialis anterior muscle increased significantly and NFOGQ decreased after the intervention. After intervention, the anteroposterior component of COP displacement showed a significant intervention effect.</div></div><div><h3>Significance</h3><div>Ankle dorsiflexion training for patients with PD improves APAs and FOG during gait initiation and may reduce the risk of falls.</div></div>\",\"PeriodicalId\":12496,\"journal\":{\"name\":\"Gait & posture\",\"volume\":\"117 \",\"pages\":\"Pages 109-114\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-12-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gait & posture\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0966636224007537\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gait & posture","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0966636224007537","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Effects of ankle dorsiflexion training on anticipatory postural adjustments during gait initiation in patients with Parkinson’s disease
Background
Freezing of gait (FOG) during gait initiation in patients with Parkinson's disease (PD) is associated with anticipatory postural adjustments (APAs) with diminishing amplitude, leading to a risk of falls. Assistance with ankle dorsiflexion function by external devices improve APAs during gait initiation, however, the effect of training to improve ankle dorsiflexion function on APAs during gait initiation is unclear.
Research question
Does ankle dorsiflexion training improve APAs and FOG during gait initiation in patients with PD?
Method
This 4-week prospective controlled trial included 30 patients with PD, who were divided into two groups: the control group, which received only conventional inpatient rehabilitation, and the intervention group, which received ankle dorsiflexion training in addition to inpatient rehabilitation. Ankle dorsiflexion training consisted of strengthening ankle dorsiflexion muscles and transferring weight backwards while standing. The primary outcomes were displacement of the center of pressure (COP) and electromyography of the tibialis anterior muscle during gait initiation as APAs. The secondary outcome was the New freezing of gait questionnaire (NFOGQ) to determine the severity of FOG. We analyzed differences in treatment effects between groups and within groups.
Result
In the intervention group, the anteroposterior component of COP displacement and muscle activity of the tibialis anterior muscle increased significantly and NFOGQ decreased after the intervention. After intervention, the anteroposterior component of COP displacement showed a significant intervention effect.
Significance
Ankle dorsiflexion training for patients with PD improves APAs and FOG during gait initiation and may reduce the risk of falls.
期刊介绍：
Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance.
The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.
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