Department of Neuro-Rehabilitation, IRCCS San Raffaele-Pisana, Roma, Italy.
J Rehabil Med. 2010 Sep;42(8):719-23. doi: 10.2340/16501977-0600.
To assess the cost of walking in individuals with multiple sclerosis and to investigate its relationship with dyspnoea and fatigue.
In 46 individuals with multiple sclerosis and in 36 healthy controls, the cost of walking was measured during the 6-min walk test. Perceived breathlessness after walking was rated on a visual analogue scale and corrected for the distance walked. The subjects' perceived effect of fatigue was assessed by means of the Modified Fatigue Impact Scale.
The cost of walking was significantly higher in individuals with multiple sclerosis than in controls; however, individuals with multiple sclerosis with normal walking speeds had normal costs of walking. The cost of walking was directly related to the degree of disability, but not to breathlessness perception and fatigue. Individuals with an Expanded Disability Status Scale score greater than 2.5 were highly likely to show an increased cost of walking. Breathlessness perception was higher than in controls and was related to fatigue.
Individuals with multiple sclerosis, even with mild disability and not requiring any assistive devices, may have an increase in cost of walking. This suggests that an aerobic training programme should be considered in these patients. Energy expenditure when walking is not a determinant of fatigue or exertional dyspnoea in individuals with multiple sclerosis and low levels of disability.
评估多发性硬化症患者行走的成本，并探讨其与呼吸困难和疲劳的关系。
在 46 名多发性硬化症患者和 36 名健康对照者中，在 6 分钟步行测试期间测量行走的成本。行走后呼吸困难的感知程度通过视觉模拟量表进行评估，并根据行走的距离进行校正。通过改良疲劳影响量表评估受试者的疲劳感知效应。
多发性硬化症患者的行走成本明显高于对照组；然而，行走速度正常的多发性硬化症患者的行走成本正常。行走成本与残疾程度直接相关，但与呼吸困难感知和疲劳无关。扩展残疾状态量表评分大于 2.5 的患者极有可能出现行走成本增加。呼吸困难感知高于对照组，与疲劳有关。
即使残疾程度较轻且不需要任何辅助设备，多发性硬化症患者也可能会增加行走成本。这表明这些患者应考虑进行有氧运动计划。在残疾程度较低的多发性硬化症患者中，行走时的能量消耗不是疲劳或运动性呼吸困难的决定因素。
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