Effects of bilateral subthalamic stimulation on gait kinematics and kinetics in Parkinson's disease

被引:90
作者
Ferrarin, M
Rizzone, M
Bergamasco, B
Lanotte, M
Recalcati, M
Pedotti, A
Lopiano, L
机构
[1] IRCCS, Fdn Don Carlo Gnocchi, Ctr Bioingn FDG, ONLUS, I-20148 Milan, Italy
[2] Univ Turin, Dipartimento Neurosci, Turin, Italy
[3] Osped Niguarda Ca Granda, Dipartimento Neurosci, Milan, Italy
[4] Fdn Salvatore Maugeri, Pavia, Italy
[5] Osped CTO, Div Neurochirurg, Turin, Italy
[6] Politecn Milan, Dipartimento Bioingn, I-20133 Milan, Italy
关键词
gait analysis; Parkinson's disease; subthalamic nucleus stimulation; deep brain stimulation; motor rehabilitation;
D O I
10.1007/s00221-004-2036-5
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Subthalamic nucleus (STN) stimulation, a recent surgical approach to Parkinson's disease (PD), has been shown to be effective in relieving motor symptoms. The present study carried out a full body gait analysis, during overground walking, on ten PD patients with bilaterally implanted STN stimulation devices. Walking performance was analyzed on the same day, in four conditions (Stim Off - Med Off, Stim On - Med Off, Stim Off - Med On, Stim On - Med On). The results showed that, on average, STN stimulation alone (S+M-) and L-dopa alone (S-M+), significantly increased gait speed, stride length and the lower limb joint Range of Motion ( ROM) with respect to the basal condition (S-M-); also cadence was found to play a role in velocity increase, particularly when L-dopa was administered. Both treatments improved pelvis and trunk kinematics, and power production at the ankle and hip joints. The combination of the two treatments (S+M+) produced an additional effect on gait speed, stride length, ROM of knee and ankle joints, pelvis obliquity and trunk inclination. Given the additive and synergistic effects, it can be hypothesized that the two treatments have different mechanisms of action. Our results confirm the findings of earlier studies that employed treadmill walking.
引用
收藏
页码:517 / 527
页数:11
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