【論文摘要】The Dual-task Effects on Postural Control in Patients With Early-stage Parkinson Disease Without Clinically Observed Postural Symptoms

【論文摘要】雙重作業對無臨床姿勢症狀之早期巴金森症患者於姿勢控制的影響

鄭之姸(Chih-Yen Cheng) ； 陳亮圻(Liang-Chi Chen) ； 吳瑞美(Ruey-Meei Wu) ； 黃正雅(Cheng-Ya Huang)

《物理治療》 45卷4期 (2020/12) Pp. 299-300

https://doi.org/10.6215/FJPT.202012.O06

摘要

Background and Purpose: Postural impairment is common in patients with Parkinson disease (PD). Because of no prominent postural symptoms, the issue of postural control ability in patients with early-stage PD has not been well investigated. On the other hand, ＂clinically observed postural symptoms＂ of early-stage PD was based on the performance of single postural tasks. However, dual-task paradigms are considered a more sensitive tool for postural control evaluation. Therefore, this study aimed to compare dual-task effects on postural control and its related brain activity between patients with early-stage PD who had no clinically observed postural symptoms and age-matched healthy adults. Methods: Sixteen patients with early-stage PD without clinically observed postural symptoms and sixteen age-matched healthy adults were recruited in this study. Participants were asked to (1) maintain balance in a tandem stance only (single-task condition), and (2) keep two interlocking rings apart and maintain balance in a tandem stance (dual-task condition). Postural sway, postural determinism (%DET), ring-touching time, and brain activity in theta band (4-8 Hz) recorded by electroencephalography were analyzed. Results: Under the single-task condition, there were no significant differences in postural sway and postural %DET between the patients with PD and the healthy subjects (postural sway: p = 0.070; postural %DET: p = 0.928). However, the patients with PD had higher theta power than the healthy subjects in Fz and FCz. When the ring-task was added, the PD patients showed greater values of postural sway and postural %DET compared to those in the healthy subjects (postural sway: p = 0.042; postural %DET: p = 0.007). In addition, the PD patients had greater theta power in bilateral frontal areas (F3/4, Fz, FC3/4, FCz) and left sensorimotor-parietal areas (C3, Cz, CP3, CPz, P3, Pz) relative to the healthy subjects under the dual-task condition. Conclusion: Patients with early-stage PD had to recruit more attentional resource for postural control (e.g. greater theta power). Besides, because much more attentional resource was devoted to the postural task, the automaticity for dual-task postural control was deteriorated (e.g., greater postural %DET) in patients with early-stage PD under the dual-task condition. Clinical Relevance: Our results provide important information that early intervention in postural balance, especially in dual-task postural control, is necessary for patients with early-stage PD, even the patients do not show clinically observed postural symptoms.