INTRODUCTION Orthostatic tremor (OT) patients frequently report gait unsteadiness with the advancement of disease; however, there is little understanding of its physiology. We sought to examine in OT, the spatial and temporal characteristics of gait, and the relationship with tremor physiology. METHODS Gait parameters for OT (n = 16) were recorded with an instrumented Zeno walkway system. All participants complained of gait unsteadiness, especially during slow walking. In a subset of OT, recordings were synchronized with a wireless EMG system for tremor assessment and feet pressure recording. Gait assessments were performed at self-selected habitual, fast, and slow speeds. RESULTS Compared to data available for an age- and sex-matched healthy controls, OT patients had a significantly reduced step length, increased step width, and increased gait variability (p < 0.0001). Tremor discharges related to OT were consistently recorded across three different speeds of walking. These discharges persisted through all phases of the gait cycle, including the swing phase when the limb was not weight-bearing. The highest tremor amplitude was recorded in the single support phase, followed by double support, and least during the swing phase. CONCLUSION OT patients have distinct gait abnormalities similar to cerebellar disorders. Tremor discharges from the non-weight bearing leg in the swing phase suggests that muscle contractions, even when occurring without resistance, contribute to OT generation.

中文翻译：

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直立性震颤患者的步态特征。

简介体位性震颤（OT）患者经常随着疾病的进展而步态不稳定。但是，对其生理学知之甚少。我们试图检查OT，步态的时空特征以及与震颤生理的关系。方法用仪器化的Zeno人行道系统记录OT（n = 16）的步态参数。所有参与者都抱怨步态不稳，尤其是在慢速行走时。在OT的一个子集中，将记录与无线EMG系统同步以进行震颤评估和足底压力记录。以自行选择的惯常，快和慢的速度进行步态评估。结果与年龄和性别相匹配的健康对照组的可用数据相比，OT患者的步长明显缩短，步幅增加，并增加步态变异性（p <0.0001）。在三种不同的步行速度下，持续记录与OT相关的震颤。这些放电持续到步态周期的所有阶段，包括肢体不承重时的摆动阶段。在单支撑阶段记录最大震颤幅度，随后是双支撑，并且在摆动阶段记录最小。结论OT患者的步态异常与小脑疾病相似。在挥杆阶段从非负重腿部震颤放电表明，即使无阻力发生，肌肉收缩也会促进OT的产生。这些放电持续到步态周期的所有阶段，包括肢体不承重时的摆动阶段。在单支撑阶段记录最大震颤幅度，随后是双支撑，并且在摆动阶段记录最小。结论OT患者的步态异常与小脑疾病相似。在挥杆阶段从非负重腿部震颤放电表明，即使没有抵抗力发生，肌肉收缩也会促进OT的产生。这些放电持续到步态周期的所有阶段，包括肢体不承重时的摆动阶段。最高震颤幅度记录在单支撑阶段，随后是双支撑，并且在摆动阶段最少。结论OT患者的步态异常与小脑疾病相似。在挥杆阶段从非负重腿部震颤放电表明，即使没有抵抗力发生，肌肉收缩也会促进OT的产生。