Background

Ankle mobility is known to be of uttermost importance to generate propulsive forces and control balance during gait initiation. Impaired mobility of the postural chain occurs with normal ageing and is exacerbated in patients with Parkinson's disease. This study questions whether short-term stretching session applied to the triceps surae improves ankle mobility and, consequently, dynamical postural control in patients with Parkinson's disease performing gait initiation.

Method

Nineteen patients with Parkinson's disease participated in this study and were randomly assigned to an “intervention group” or a “sham group”. In the intervention group, patients were exposed to a 4 × 60 seconds triceps surae stretching. In the sham group, they were exposed to forearm stretching. Additionally, ten age-matched healthy elderly, who were not exposed to any stretching-treatment, were assigned to a “control group”. Participants performed series of gait initiation on a force-plate before and after their treatment.

Findings

Ankle mobility was improved in the intervention group after triceps surae stretching. The forward velocity of the center-of-mass at heel-off and motor performance related-parameters (progression velocity, center-of-mass velocity at foot-contact and swing phase duration) were also improved in the intervention group, with large effect sizes (d ≥ 0.8). None of the stability parameters were modified by the treatments.

Interpretation

Short-term triceps surae stretching is an efficient method to increase ankle mobility and improve the capacity to generate forward propulsive forces in patients with Parkinson's disease. These findings are congruent with the “posturo-kinetics capacity” theory according to which dynamical postural control depends on postural chain mobility.

中文翻译：

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小腿三头肌短期拉伸对帕金森病患者踝关节活动度和步态起始的急性影响

背景

众所周知，踝关节的灵活性对于在步态开始期间产生推进力和控制平衡至关重要。正常衰老时会出现姿势链的活动性受损，并且在帕金森病患者中会加剧。本研究质疑应用于小腿三头肌的短期拉伸训练能否改善踝关节活动度，从而改善帕金森病患者开始步态时的动态姿势控制。

方法

19 名帕金森病患者参与了这项研究，并被随机分配到“干预组”或“假手术组”。在干预组中，患者接受 4×60 秒的小腿三头肌拉伸。在假手术组中，他们进行了前臂拉伸。此外，10 名年龄相匹配的健康老年人，没有接受任何拉伸治疗，被分配到“对照组”。参与者在治疗前后在测力板上进行了一系列步态启动。

发现

干预组在小腿三头肌拉伸后踝关节活动度得到改善。干预组的足跟离地质心前向速度和运动性能相关参数（前进速度、足部接触质心速度和摆动阶段持续时间）也得到改善，效果显着尺寸（d≥0.8）。处理没有改变任何稳定性参数。

解释

短期小腿三头肌拉伸是增加帕金森病患者踝关节活动度和提高产生向前推进力的能力的有效方法。这些发现与“姿势动力学能力”理论一致，根据该理论，动态姿势控制取决于姿势链的移动性。