Background

Individuals with Parkinson's disease present arm swing alterations that can adversely affect their locomotion.

Objective

To identify differences in arm swing asymmetry (ASA) between individuals with Parkinson's disease (PD) and healthy individuals and to investigate the relationship between ASA, temporal-spatial gait parameters, and disease progression.

Methods

A literature search was conducted in PubMed, Scopus, ProQuest, Web of Science, and EBSCOhost up to February 2023. Cross-sectional studies evaluating parameters of arm swing (AS) and ASA were included. Methodological quality was assessed using the Critical Appraisal Checklist, and the quality of the evidence was measured with a modified Grading of Recommendations Assessment, Development, and Evaluation.

Results

Fourteen studies were included in the systematic review (1130 participants). Irrespective of the medication phase (ON or OFF) and the type of walk test employed, the meta-analysis showed moderate-quality evidence that individuals with PD have increased ASA amplitude (SMD = 0.84; 95% CI: 0.69, 0.99; I²= 0%).Very low-quality evidence suggests higher ASA velocity (SMD=0.64; 95% CI: 0.24, 1.05; I²=59%) and lower AS amplitude on both the most affected (ES = -1.99, 95% CI: -3.04, -0.94, I²: 91%) and the least affected sides (ES = -0.75, 95% CI: -1.05, -0.44; I²=66%). Meta-regression indicated that ASA is inversely related to disease duration (Z: -2.4892, P< 0.05) and motor symptoms progression (Z: -2.1336, P< 0.05).

Conclusions

Regardless of the medication phase and the type of walk test employed, individuals with PD exhibited greater ASA and decreased AS amplitude than healthy individuals. ASA decreases as the disease progresses and symptoms worsen.

中文翻译：

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帕金森病患者手臂摆动不对称及其与步态的关系：系统评价和荟萃分析

背景

患有帕金森病的人会出现手臂摆动的改变，这可能会对他们的运动产生不利影响。

客观的

旨在确定帕金森病 (PD) 患者与健康个体之间手臂摆动不对称性 (ASA) 的差异，并研究 ASA、时空步态参数和疾病进展之间的关系。

方法

截至 2023 年 2 月，在 PubMed、Scopus、ProQuest、Web of Science 和 EBSCOhost 中进行了文献检索。其中包括评估摆臂 (AS) 和 ASA 参数的横断面研究。使用批判性评估清单评估方法质量，并使用修改后的建议评估、制定和评估分级来衡量证据质量。

结果

系统评价纳入了 14 项研究（1130 名参与者）。无论药物治疗阶段（开启或关闭）和所采用的步行测试类型如何，荟萃分析显示中等质量的证据表明 PD 患者 ASA 幅度增加（SMD = 0.84；95% CI：0.69，0.99；I²= 0%）。非常低质量的证据表明，受影响最严重的两个患者的 ASA 速度较高（SMD=0.64；95% CI：0.24，1.05；I²=59%），AS 幅度较低（ES = -1.99，95% CI： -3.04，-0.94，I ²：91%）和受影响最小的一侧（ES = -0.75，95% CI：-1.05，-0.44；I²=66%）。Meta回归表明ASA与疾病持续时间（Z：-2.4892，P < 0.05）和运动症状进展（Z：-2.1336，P < 0.05）呈负相关。

结论

无论药物治疗阶段和采用哪种步行测试类型，PD 患者都比健康个体表现出更高的 ASA 和更低的 AS 幅度。ASA 随着疾病进展和症状恶化而降低。