可穿戴设备数字化评估多巴丝肼对不同站姿条件下帕金森病患者平衡稳定性的影响

Effect of levodopa and benserazide hydrochloride on static balance stability of patients with Parkinson disease under different standing positions:digital evaluation methods with wearable device

目的:采用可穿戴设备评估多巴丝肼对帕金森病(PD)患者服药前后平衡稳定性的影响。方法:选取Hoehn&Yahr(H&Y)3级PD患者及年龄匹配的健康受试者。通过可穿戴式传感器采集药物开期状态及药物关期状态下PD患者和健康受试者睁眼自然站立、睁眼并脚站立、闭眼自然站立时的平衡能力。比较两组受试者在不同姿态下的前后/左右摆动位移(重心摆动参数)。结果:12例H&Y 3级PD患者及12例健康受试者入组,两组年龄、性别、蒙特利尔认知评估量表(MoCA)评分差异无统计学意义。健康对照组闭眼自然站立时摇摆位移较睁眼自然站立时减小(P<0.05)。PD患者药物开期和药物关期的摇摆位移差异无统计学意义。睁眼自然站立状态下,PD组患者药物关期前后摇摆位移小于健康对照组(P<0.05);闭眼自然站立状态下,PD组患者药物开期左右摇摆位移大于健康对照组(P<0.05)。结论:数字化可穿戴设备可有效评估PD患者与健康人的平衡能力;多巴丝肼未能显著改善患者的平衡调节能力;PD患者可能存在视觉与体感平衡感觉整合异常。

Objective：To evaluate the effect of levodopa and benserazide hydrochloride on static balance stability patients with of Parkinson disease（PD）by using wearable device.Methods：PD patients with Hoehn Yahr stage of grade 3 were enrolled and age-matched healthy subjects were selected as control group.The balance stability data under different positions,including natural standing with open eyes,standing on the feet with open eyes and natural standing with close eyes,were recorded by wearable sensor in ON and OFF state of drug.The swing displacements of antero-posterior/medio-lateral（the center of gravity swing parameters）under different standing positions were compared between two groups.Results：Totally 12 PD patients with Hoehn Yahr stage of grade 3 and 12 healthy subjects were selected.The age,gender,and score of Montreal cognitive assessment（MoCA）were not significantly different between two groups.In control group,the swing displacement under position of natural standing with open eyes was significantly less than that under position of natural standing with close eyes（P〈0.05）.In PD group,the swing displacement was not significantly changed in ON and OFF stage of drug.However,under position of natural standing with open eyes,the displacement of antero-posterior swing in PD group was significantly less than that in control group in OFF state of the drug（P〈0.05）;under naturally standing state with close eyes,the displacement of medio-lateral swing in PD group was significantly greater than that in control group（P〈0.05）.Conclusions：Digital wearable devices can effectively assess the balance stability of PD patients and healthy people;levodopa and benserazide hydrochloride do not improve the balance capacity of PD patients significantly;PD patients may have abnormal integration of visual and somatosensory.