Background

Gait initiation is an automatized motor program that is preceded by anticipatory postural adjustments (APAs). During attentional tasks, these APAs can be modulated, producing multiple APAs. However, the role of the peripheral nervous system in the regulation of these APAs is unknown.

Research question

The objective of our study was to investigate whether APAs are also regulated by peripheral nervous afferents.

Methods

We assessed 21 patients suffering from chronic inflammatory demyelinating neuropathy and 20 healthy controls. Participants initiated gait with the right or left leg either freely (in the standard condition) or according to a visual trigger (i.e., the select condition). Kinetic and kinematic parameters of APAs and step initiation were recorded.

Results

The select condition was related to a higher rate of multiple APAs compared to the standard condition, and was more attention-consuming in both groups. The group with a neuropathy showed longer APAs than the control group, associated with a longer time to recover from multiple APAs. Consequently, the step execution time was delayed in patients with a peripheral neuropathy.

Significance

The impairment of the peripheral nervous system is therefore responsible for an alteration of the mechanisms underlying the recovery from multiple APAs during gait initiation. Our results are in favor of a role of proprioceptive afferents in the early peripheral regulation of motor errors. Further study on gait initiation in peripheral nervous disease could be helpful to better explore sensory-motor coupling in tasks requiring balance control.

中文翻译：

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外周神经系统在慢性炎性脱髓鞘性多发性神经病患者步态开始时为适当姿势准备的作用：一项初步研究

背景

步态启动是一种自动化的运动程序，之前是预期姿势调整 (APA)。在注意力任务期间，这些 APA 可以被调节，产生多个 APA。然而，外周神经系统在调节这些 APA 中的作用尚不清楚。

研究问题

我们研究的目的是调查 APA 是否也受外周神经传入的调节。

方法

我们评估了 21 名患有慢性炎性脱髓鞘神经病变的患者和 20 名健康对照者。参与者自由地（在标准条件下）或根据视觉触发（即，选择条件）用右腿或左腿开始步态。记录了 APA 的动力学和运动学参数以及步骤启动。

结果

与标准条件相比，选择条件与多个 APA 的发生率更高有关，并且在两组中都更加引人注目。与对照组相比，神经病变组显示出更长的 APA，这与从多个 APA 中恢复的时间更长有关。因此，周围神经病变患者的步骤执行时间被延迟。

意义

因此，外周神经系统的损伤是导致步态启动期间从多个 APA 恢复的潜在机制改变的原因。我们的结果支持本体感受传入在运动错误的早期外周调节中的作用。对周围神经疾病步态起始的进一步研究可能有助于更好地探索需要平衡控制的任务中的感觉-运动耦合。