Scivoletto Giorgio, Romanelli Angela, Mariotti Andrea, Marinucci Daniele, Tamburella Federica, Mammone Alessia, Cosentino Elena, Sterzi Silvia, Molinari Marco
Spinal Cord Unit, IRCCS Fondazione Santa Lucia, Rome, Italy.
Spine (Phila Pa 1976). 2008 Feb 1;33(3):259-64. doi: 10.1097/BRS.0b013e3181626ab0.
Observational Study.
To evaluate the effects of neurologic and non-neurologic factors on walking level and performance in chronic spinal cord lesion (SCL) patients.
Walking is one of the primary goals of patients after a SCL. Several studies have demonstrated that different neurologic and non-neurologic factors can affect walking level and performance. However, in SCL age and muscle strength have always been considered the major determinants of walking.
Sixty-five patients with chronic SCL were included. Their demographic, neurologic status (ASIA standards), balance, and spasticity were recorded. Pearson and Spearman correlations were adopted to quantify the association between patients' characteristics and walking ability. The relationship between functional walking measures, Timed Up and Go, Six Minutes Walking Test (SMWT), Ten Meters Walking Test, and Walking Index for Spinal Cord Injury, and demographic and neurologic factors were measured by regression analyses.
Strength, balance, spasticity, and age were strictly correlated with walking level and walking performance. They also were the best predictors of walking features.
Results confirm the recognized importance of age and upper and lower extremity strengths for walking after a SCL. They also highlight the role of 2 other factors, i.e., balance and spasticity, seldom considered as thoroughly in SCL.
观察性研究。
评估神经学和非神经学因素对慢性脊髓损伤(SCL)患者步行水平和表现的影响。
步行是脊髓损伤患者的主要目标之一。多项研究表明,不同的神经学和非神经学因素会影响步行水平和表现。然而,在脊髓损伤中,年龄和肌肉力量一直被视为步行的主要决定因素。
纳入65例慢性脊髓损伤患者。记录他们的人口统计学信息、神经学状态(ASIA标准)、平衡能力和痉挛情况。采用Pearson和Spearman相关性分析来量化患者特征与步行能力之间的关联。通过回归分析测量功能性步行指标、定时起立行走测试、六分钟步行测试(SMWT)、十米步行测试和脊髓损伤步行指数与人口统计学和神经学因素之间的关系。
力量、平衡能力、痉挛情况和年龄与步行水平和步行表现密切相关。它们也是步行特征的最佳预测指标。
研究结果证实了年龄以及上肢和下肢力量在脊髓损伤后步行中的重要性,这一点已得到公认。研究结果还凸显了另外两个因素的作用,即平衡能力和痉挛情况,在脊髓损伤中它们很少被如此全面地考虑。