Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado, Anschutz Medical Center, Aurora, CO 80045, United States.
Gait Posture. 2013 May;38(1):37-42. doi: 10.1016/j.gaitpost.2012.10.015. Epub 2012 Nov 28.
Fatigue and impaired upright postural control (balance) are the two most common complaints in persons with multiple sclerosis (MS), with limited evidence on how they are related.
To examine the relationship between symptomatic fatigue and balance as a function of central sensory integration in persons with multiple sclerosis.
Seventeen persons with relapsing-remitting MS were enrolled in this cross-sectional study. Primary measurements included fatigue (modified fatigue impact scale - MFIS); balance (dynamic posturography, sensory organization testing - SOT); and walking capacity (six-minute walk test - 6MWT).
Fatigue scores were significantly associated with balance: MFIS total (r=-0.78; p<0.001), physical subscale (r=-0.77; p<0.001), cognitive subscale (r=-0.75; p=0.001) and psychosocial subscale (r=-0.53; p=0.030) scores. MFIS total score was a significant predictor of balance (p≤0.001), accounting for 62% of the variability in SOT composite scores. Significant differences in fatigue (d=1.75; p=0.005) and balance (d=1.74; p=0.005) were found for participants who had cerebellar and brainstem involvement compared to those without.
Symptomatic fatigue is significantly related to balance and is a significant predictor of balance as a function of central sensory integration in persons with MS. Fatigue and balance are associated with cerebellar and brainstem involvement. This study provides early evidence supporting the theory that for those persons with MS who struggle to maintain steady balance during tasks that stimulate the central sensory integration process, complaints of significant levels of fatigue are probable.
疲劳和直立姿势控制（平衡）受损是多发性硬化症（MS）患者最常见的两种抱怨，关于它们之间的关系，证据有限。
研究多发性硬化症患者的症状性疲劳与平衡之间的关系，作为中枢感觉综合的功能。
本横断面研究纳入了 17 名复发性缓解型多发性硬化症患者。主要测量包括疲劳（改良疲劳影响量表-MFIS）；平衡（动态姿势描记术，感觉组织测试-SOT）；和行走能力（6 分钟步行测试-6MWT）。
疲劳评分与平衡显著相关：MFIS 总分（r=-0.78；p<0.001），身体子量表（r=-0.77；p<0.001），认知子量表（r=-0.75；p=0.001）和心理社会子量表（r=-0.53；p=0.030）评分。MFIS 总分是平衡的显著预测指标（p≤0.001），占 SOT 综合评分变异性的 62%。与无小脑和脑干受累的患者相比，有小脑和脑干受累的患者在疲劳（d=1.75；p=0.005）和平衡（d=1.74；p=0.005）方面存在显著差异。
症状性疲劳与平衡显著相关，是多发性硬化症患者中枢感觉综合功能平衡的重要预测指标。疲劳和平衡与小脑和脑干受累有关。本研究为中枢感觉整合过程中任务稳定平衡困难的多发性硬化症患者，疲劳水平显著升高的可能性提供了早期证据。
