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在不完全性脊髓损伤后,曲线行走在评估与步行相关的领域方面并不优于直线行走。

Curve walking is not better than straight walking in estimating ambulation-related domains after incomplete spinal cord injury.

机构信息

Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.

出版信息

Arch Phys Med Rehabil. 2012 May;93(5):796-801. doi: 10.1016/j.apmr.2011.11.009. Epub 2012 Mar 2.

Abstract

OBJECTIVES

To investigate whether a figure-of-8-shaped walking test can estimate various domains of walking in subjects with incomplete spinal cord injury (iSCI) better than the 10-meter walk test (10MWT), and to explore similarities and differences between the 2 tests and between subjects with iSCI and age-matched, healthy controls.

DESIGN

Case-control study.

SETTING

Spinal cord injury center of a university hospital.

PARTICIPANTS

A convenience sample of subjects with iSCI (n=15; mean age, 50y; 40% women; neurologic level from C3 to L5; median time since injury, 5mo) was compared with an age-matched control group (47% women).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The figure-of-8 test (FET) included 6 conditions to test the subjects' ability to adapt their gait to several circumstances. These conditions covered normal and maximal walking speed, constrained vision, obstacles, foamed soles, and a dual task. Additionally, subjects were tested for lower extremity muscle strength, gait capacity (10MWT) and balance, independence, and fear of falling.

RESULTS

(1) Preferred straight-walking speed correlated with the different FET conditions in both groups; (2) if normalized to preferred straight-walking speed, FET conditions showed significant differences between both groups; (3) if normalized to preferred curve-walking speed, these differences seemed to disappear; and (4) the 10MWT appeared superior to the different conditions of the FET in estimating various walking-related functions.

CONCLUSIONS

Subjects with iSCI seem to have difficulties with curve walking compared with straight walking. We therefore recommend the implementation of curve walking into rehabilitation training programs. However, the FET did not provide a better estimate of functional ambulation performance after an iSCI compared with the 10MWT.

摘要

目的

研究 8 字形走测试是否比 10 米步行测试(10MWT)更能评估不完全性脊髓损伤(iSCI)患者的各种步行能力,并探讨两种测试之间以及 iSCI 患者与年龄匹配的健康对照组之间的相似性和差异性。

设计

病例对照研究。

地点

一所大学医院的脊髓损伤中心。

参与者

15 名 iSCI 患者(平均年龄 50 岁;40%为女性;神经损伤水平 C3-L5;损伤后中位时间 5 个月)组成方便样本,与年龄匹配的对照组(47%为女性)进行比较。

干预措施

无。

主要观察指标

8 字形测试(FET)包括 6 种条件,以测试受试者适应不同环境下行走的能力。这些条件涵盖了正常和最大行走速度、受限视野、障碍物、泡沫鞋底以及双重任务。此外,还对受试者的下肢肌肉力量、步态能力(10MWT)和平衡、独立性以及跌倒恐惧进行了测试。

结果

(1)在两组中,偏好直线行走速度与 FET 的不同条件均相关;(2)如果归一化为偏好直线行走速度,FET 条件在两组之间存在显著差异;(3)如果归一化为偏好曲线行走速度,这些差异似乎消失;(4)10MWT 似乎比 FET 的不同条件更能估计各种与行走相关的功能。

结论

与直线行走相比,iSCI 患者在曲线行走时似乎存在困难。因此,我们建议将曲线行走纳入康复训练计划。然而,与 10MWT 相比,FET 并不能更好地估计 iSCI 后的功能性步行能力。

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