Souza Ana, Kelleher Annmarie, Cooper Rosemarie, Cooper Rory A, Iezzoni Lisa I, Collins Diane M
Human Engineering Research Laboratories, Department of Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA.
J Rehabil Res Dev. 2010;47(3):213-23. doi: 10.1682/jrrd.2009.07.0096.
Multiple sclerosis (MS) causes a wide variety of neurological deficits, with ambulatory impairment the most obvious cause of disability. Within 10 to 15 years of disease onset, 80% of persons with MS experience gait problems due to muscle weakness or spasticity, fatigue, and loss of balance. To facilitate mobility, persons with MS frequently use mobility assistive technology (MAT), such as canes, crutches, walkers, wheelchairs, and scooters. We systematically reviewed the published literature on MAT use among persons with MS. We used electronic reference lists such as Ovid MEDLINE and PubMed to search the literature. We located 50 articles that met the initial criteria of providing good evidence of the types of MAT devices and their benefits for individuals with MS. A limited number of articles with higher levels of evidence was found regarding benefits of MAT use specifically for persons with MS. Evidence-based literature provides the basis for the strongest method of measurable clinical performance; therefore, having a strong research study design is vital to the justification of MAT prescription and reimbursement decisions. However, a paucity of studies with higher levels of evidence-based practice exists.
多发性硬化症(MS)会引发多种神经功能缺损,其中行动障碍是导致残疾的最明显原因。在疾病发作后的10至15年内,80%的MS患者会因肌肉无力或痉挛、疲劳以及平衡能力丧失而出现步态问题。为了便于行动,MS患者经常使用移动辅助技术(MAT),如手杖、拐杖、助行器、轮椅和小型摩托车。我们系统地回顾了已发表的关于MS患者使用MAT的文献。我们利用诸如Ovid MEDLINE和PubMed等电子参考文献列表来检索文献。我们找到了50篇符合初步标准的文章,这些文章提供了MAT设备类型及其对MS患者益处的有力证据。关于MAT使用对MS患者的益处,我们发现只有少数几篇证据水平较高的文章。基于证据的文献为可衡量的临床性能的最强方法提供了基础;因此,拥有强大的研究设计对于MAT处方和报销决策的合理性至关重要。然而,缺乏高水平循证实践的研究。