Background. Previous studies found levodopa could improve the activity of the ankle joints of patients with Parkinson’s disease (PD). But ankle joint movement is composed of four motion ranges. The specific changes of four motion ranges in PD remain unknown. Objective. The purpose of this study was to decompose the complex ankle joint movement, measure ankle joint changes before and after the acute levodopa challenge test (ALCT), and investigate the effects of these parameters on gait performance. Methods. 29 PD patients and 30 healthy control subjects (HC) completed the Instrumented Stand and Walk (ISAW) test and gait parameters were collected by the JiBuEn gait analysis system. The percentage of improvement of gait data and the UPDRS III in the on-drug condition (ON) were determined with respect to the off-drug condition (OFF). Results. We observed a reduction in the heel strike angle (HS), 3-plantarflexion (3-PF) angle, and 4-dorsiflexion (4-DF) angle of ankle joints. We did not find significant difference in the toe-off angle (TO), 1-plantarflexion (1-PF) angle, and 2-dorsiflexion (2-DF) angle among three groups. Stride length improvement rate was significantly correlated with HS (r_s = 0.616, ) and 3-PF (r_s = 0.639, ) improvement rates. The improvement in the sum of rigidity items (UPDRS motor subsection item 22) was also correlated with HS (r_s = 0.389, ) and 3-PF (r_s = 0.373, ) improvement rates. Conclusions. Exogenous levodopa supplementation can significantly reduce the rigidity of patients with PD, improve their 3-PF and 4-DF of ankle joint kinematic parameters, and ultimately enhance their gait.

中文翻译：

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可穿戴传感器测量帕金森病患者急性左旋多巴挑战前后踝关节的变化。

背景。先前的研究发现左旋多巴可以改善帕金森病（PD）患者踝关节的活动。但踝关节运动由四个运动范围组成。PD中四个运动范围的具体变化仍然未知。客观。本研究的目的是分解复杂的踝关节运动，测量急性左旋多巴激发试验（ALCT）前后踝关节的变化，并研究这些参数对步态表现的影响。方法. 29 名 PD 患者和 30 名健康对照者 (HC) 完成了仪器站立和行走 (ISAW) 测试，并通过 JiBuEn 步态分析系统收集了步态参数。相对于非药物条件 (OFF) 确定在药物条件 (ON) 中步态数据和 UPDRS III 改善的百分比。结果。我们观察到踝关节的足跟触角 (HS)、3-跖屈 (3-PF) 角和 4-背屈 (4-DF) 角减小。我们没有发现三组之间的脚趾离角（TO）、1-跖屈（1-PF）角和2-背屈（2-DF）角有显着差异。步长改善率与 HS ( r _s  = 0.616, )和 3-PF ( r _s = 0.639, )改善率。_{刚度项目总和（UPDRS 电机小节项目 22）的}改善也与 HS（rs  = 0.389，）和 3-PF（_rs =  0.373，）改善率相关。结论。外源性左旋多巴补充剂可显着降低 PD 患者的僵硬，改善其踝关节运动学参数的 3-PF 和 4-DF，最终改善其步态。