Busse M E, Wiles C M, van Deursen R W M
Research Centre for Clinical Kinaesiology, Department of Physiotherapy, Cardiff University, Ty Dewi Sant, Heath Park, Cardiff, CF14 4XN, UK.
J Neurol Neurosurg Psychiatry. 2006 Mar;77(3):359-62. doi: 10.1136/jnnp.2005.074294.
The aims of this study were to determine walking mobility in the community in individuals with lower limb weakness and to establish the extent to which some clinic based measures predict such activity.
Five groups (n = 12-18) of independently ambulant patients with lower limb weakness due to neurological conditions and a matched healthy control group were recruited. Measures of isometric knee extension/flexion muscle strength, time to stand up (sit-to-stand, STS), gait speed, and daily step counts (recorded over 7 days) were obtained. The Rivermead Mobility Index (RMI) provided a measure of functional ability. Between group differences and associations were explored. Backward stepwise regression analysis was used to identify variables influencing daily step count in individuals with neurological impairment.
Patients were significantly weaker (mean (SD) quadriceps strength 69+/-34% v 102+/-37% predicted), slower to stand up (2.9+/-1.3 v 2.0+/-0.6 s), and had slower self selected gait speed (0.74+/-0.3 v 1.2+/-0.2 m/s) than controls. Mean daily step count was also lower (3090+/-1902 v 6374+/-1819) than in controls. In neurology patients step count was correlated with RMI score (r(s) = 0.49, p<0.01) and STS (r = -0.19, p<0.05). However, self selected gait speed was the only significant predictor in the regression analysis (p<0.01) of daily mean step count.
Measures of muscle strength, timed STS, and RMI do not appear to closely reflect community walking activity in these patient groups. Self selected gait speed was partially predictive. Measurement of community walking activity may add a new dimension to evaluating the impact of interventions in neurological disorders.
本研究旨在确定下肢无力个体在社区中的行走能力，并确定一些基于诊所的测量方法对这种活动的预测程度。
招募了五组（每组n = 12 - 18）因神经系统疾病导致下肢无力且能独立行走的患者，以及一组匹配的健康对照组。获取了等长膝关节伸展/屈曲肌肉力量、站立时间（从坐到站，STS）、步态速度和每日步数（记录7天）的测量值。Rivermead运动指数（RMI）提供了功能能力的测量。探讨了组间差异和相关性。采用向后逐步回归分析来确定影响神经功能障碍个体每日步数的变量。
与对照组相比，患者的力量明显较弱（股四头肌力量平均（标准差）为预测值的69±34%对102±37%），站立速度较慢（2.9±1.3对2.0±0.6秒），自我选择的步态速度也较慢（0.74±0.3对1.2±0.2米/秒）。平均每日步数也低于对照组（3090±1902对6374±1819）。在神经科患者中，步数与RMI评分（r(s) = 0.49，p<0.01）和STS（r = -0.19，p<0.05）相关。然而，在每日平均步数的回归分析中，自我选择的步态速度是唯一显著的预测因素（p<0.01）。
肌肉力量、定时STS和RMI的测量似乎不能紧密反映这些患者群体在社区中的行走活动。自我选择的步态速度具有部分预测性。社区行走活动的测量可能会为评估神经系统疾病干预措施的影响增加一个新的维度。
