Gait disturbances in people with Parkinson’s disease (PD) are a major cause for functional dependence and have recently been shown to be the largest risk factor for falls, institutionalization and death in PD. The use of external cues has been successful at improving gait in people with PD, but the effect of external cues on gait stability is unclear. We examined whether different forms of cueing, open-loop and closed-loop, influenced the local dynamic stability of three critical phases of gait. Forty-three adults with PD completed six, two-minute long walking trials in the following cued conditions: no cue (B), open-loop cueing, fixed auditory cue (OL), closed-loop cueing, tactile feedback delivered to wrist when the ipsilateral foot contacted with the ground (CL). Conditions were performed with and without a cognitive task. Kinematic data were recorded with inertial sensors. Only CL cueing was associated with changes in trunk stability, and these changes were only evident during the weight transfer phase of gait. Both OL and CL caused reductions in overall gait speed, stride length, and an increase in stride time. While CL cueing significantly influenced local dynamic stability during weight transfer, it remains unknown whether these changes are associated with more or less global stability. Future research will explore the clinical implications.

中文翻译：

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闭环触觉反馈对帕金森氏病步态稳定性的相位依赖性效应。

帕金森氏病（PD）患者的步态障碍是功能依赖性的主要原因，最近已证明是跌倒，机构化和PD死亡的最大危险因素。使用外部提示已成功地改善了PD患者的步态，但是尚不清楚外部提示对步态稳定性的影响。我们检查了不同形式的提示，开环和闭环是否影响了步态三个关键阶段的局部动态稳定性。有PD的四十三名成年人在以下提示条件下完成了六次，两分钟的长时间步行试验：无提示（B），开环提示，固定听觉提示（OL），闭环提示，触觉反馈传递给手腕时同侧脚与地面（CL）接触。在有或没有认知任务的情况下执行条件。运动数据用惯性传感器记录。只有CL提示与躯干稳定性的变化有关，并且这些变化仅在步态的重量传递阶段明显。OL和CL都导致整体步态速度，步幅降低和步幅时间增加。虽然CL提示会显着影响重量传递过程中的局部动态稳定性，但这些变化是否与总体稳定性有关还是未知的。未来的研究将探索其临床意义。虽然CL提示会显着影响重量传递过程中的局部动态稳定性，但这些变化是否与总体稳定性有关还是未知的。未来的研究将探索其临床意义。虽然CL提示会显着影响重量传递过程中的局部动态稳定性，但这些变化是否与总体稳定性有关还是未知的。未来的研究将探索其临床意义。