Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
Arch Phys Med Rehabil. 2010 Jan;91(1):93-9. doi: 10.1016/j.apmr.2009.09.013.
Sosnoff JJ, Shin S, Motl RW. Multiple sclerosis and postural control: the role of spasticity.
To examine the association between spasticity and postural control in subjects with multiple sclerosis (MS).
Cross-sectional.
Motor control laboratory.
Subjects with MS (n=16, 2 male) and age and sex-matched subjects (n=16) participated in the investigation. All subjects with MS had Expanded Disability Status Scale scores between 0 and 4.5 and modified Ashworth scale scores between 1 and 3.
Not applicable.
Postural control was measured with a force platform that quantifies ground reaction forces and moments in mediolateral and anteroposterior directions. Postural control was indexed with anterior-posterior sway range, medial-lateral sway range, 95% elliptical area of the deviations of center of pressure (COP), velocity of COP sway, and the frequency at which 95% of spectral profile was contained. Participants with MS further underwent assessment of the soleus Hoffman reflex (H-reflex) as an index of spasticity.
Cluster analysis on H-reflex data identified groups of MS participants with high spasticity (n=7) and low spasticity (n=9). There were no differences in age, duration of MS, and disease severity between MS groups. There were no differences in anterior-posterior sway range between any of the groups. The high spasticity group had greater COP area, velocity, and mediolateral sway compared with the low spasticity and control group, and the low spasticity group had postural control values between the high spasticity and control groups.
The pattern of results suggests that spasticity contributes to postural deficits observed in MS.
Sosnoff JJ、Shin S、Motl RW。多发性硬化症与姿势控制：痉挛的作用。
检查多发性硬化症（MS）患者痉挛与姿势控制之间的关联。
横断面研究。
运动控制实验室。
16 名 MS 患者（2 名男性）和年龄、性别匹配的参与者（16 名）参加了研究。所有 MS 患者的扩展残疾状况量表（EDSS）评分在 0 到 4.5 之间，改良 Ashworth 量表评分在 1 到 3 之间。
不适用。
姿势控制通过力平台进行测量，该平台可量化在前后和左右方向的地面反作用力和力矩。姿势控制通过前后摆动范围、左右摆动范围、压力中心（COP）偏差的 95%椭圆面积、COP 摆动速度以及包含 95%光谱分布的频率来进行指标评估。MS 患者进一步接受比目鱼肌 Hoffmann 反射（H-反射）评估，作为痉挛的指标。
基于 H-反射数据的聚类分析，确定了高痉挛（n=7）和低痉挛（n=9）MS 患者的分组。MS 患者组之间在年龄、MS 持续时间和疾病严重程度方面没有差异。在任何组之间，前后摆动范围都没有差异。高痉挛组的 COP 面积、速度和左右摆动都比低痉挛组和对照组大，而低痉挛组的姿势控制值介于高痉挛组和对照组之间。
结果模式表明，痉挛导致了 MS 中观察到的姿势缺陷。
