左旋多巴
物理医学与康复
帕金森病
步态
评定量表
运动学
心理学
医学
物理疗法
疾病
内科学
发展心理学
物理
经典力学
作者
Raquel Barbosa,Marcelo Mendonça,Paulo Bastos,Patrı́cia Pita Lobo,Anabela Valadas,Leonor Correia Guedes,Joaquim J. Ferreira,Mário Miguel Rosa,Ricardo Matias,Miguel Coelho
摘要
Abstract Background Quantitative 3D movement analysis using inertial measurement units (IMUs) allows for a more detailed characterization of motor patterns than clinical assessment alone. It is essential to discriminate between gait features that are responsive or unresponsive to current therapies to better understand the underlying pathophysiological basis and identify potential therapeutic strategies. Objectives This study aims to characterize the responsiveness and temporal evolution of different gait subcomponents in Parkinson's disease (PD) patients in their OFF and various ON states following levodopa administration, utilizing both wearable sensors and the gold‐standard MDS‐UPDRS motor part III. Methods Seventeen PD patients were assessed while wearing a full‐body set of 15 IMUs in their OFF state and at 20‐minute intervals following the administration of a supra‐threshold levodopa dose. Gait was reconstructed using a biomechanical model of the human body to quantify how each feature was modulated. Comparisons with non‐PD control subjects were conducted in parallel. Results Significant motor changes were observed in both the upper and lower limbs according to the MDS‐UPDRS III, 40 minutes after levodopa intake. IMU‐assisted 3D kinematics detected significant motor alterations as early as 20 minutes after levodopa administration, particularly in upper limbs metrics. Although all “pace‐domain” gait features showed significant improvement in the Best‐ON state, most rhythmicity, asymmetry, and variability features did not. Conclusion IMUs are capable of detecting motor alterations earlier and in a more comprehensive manner than the MDS‐UPDRS III. The upper limbs respond more rapidly to levodopa, possibly reflecting distinct thresholds to levodopa across striatal regions.
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