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多发性硬化症患者使用仪器跑步机测量的时空步态参数与跌倒恐惧之间的关系。

The relationship between fear of falling to spatiotemporal gait parameters measured by an instrumented treadmill in people with multiple sclerosis.

机构信息

Multiple Sclerosis Center, Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel.

Multiple Sclerosis Center, Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel.

出版信息

Gait Posture. 2014 Feb;39(2):739-44. doi: 10.1016/j.gaitpost.2013.10.012. Epub 2013 Oct 19.

Abstract

People with multiple sclerosis (MS) identify mobility limitations as one of the greatest challenges of this disease. Continued loss of mobility and falls are among their greatest concerns for the future. Our objective was to determine if fear of falling is associated with spatial and temporal gait parameters in persons with MS, when measured by an instrumented treadmill. This observational case control study was performed at the MS Center, Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel. Sixty-eight relapsing-remitting patients diagnosed with MS, 38 women, aged 40.9 (S.D. = 11.9), participated in this investigation. Twenty-five healthy subjects, 14 women, aged 39.5 (S.D. = 9.4) served as controls gait controls. Gait spatiotemporal parameters were obtained using the Zebris FDM-T Treadmill (Zebris(®) Medical GmbH, Germany). The Falls Efficacy Scale International was used to assess the level of concern relating to falls. Forty-one people with MS were classified as highly fearful of falling. Twenty-seven patients were slightly concerned. Highly fearful of falling patients walked slower had a shorter step length, a wider base of support and prolonged double support phase compared to slightly concerned patients. Fearful patients also demonstrated elevated variability of the center of pressure (CoP) trajectory compared to slightly concerned MS patients. Fear of falling and spatiotemporal gait alterations in people with MS are linked. Additionally, variability of the CoP during walking appears to be connected with the level of concern.

摘要

多发性硬化症(MS)患者将行动受限视为该疾病最大的挑战之一。持续丧失行动能力和跌倒仍是他们对未来最大的担忧之一。我们的目的是确定在使用跑步机进行测量时,多发性硬化症患者的跌倒恐惧是否与空间和时间步态参数相关。这项观察性病例对照研究在以色列谢巴医疗中心先进康复技术中心的多发性硬化症中心进行。68 名复发缓解型多发性硬化症患者,38 名女性,年龄 40.9(标准差=11.9),参与了此项研究。25 名健康对照者,14 名女性,年龄 39.5(标准差=9.4),作为对照。使用 Zebris FDM-T 跑步机(Zebris(®)Medical GmbH,德国)获取步态时空参数。使用国际跌倒效能量表评估与跌倒相关的担忧程度。41 名多发性硬化症患者被归类为高度害怕跌倒。27 名患者稍有顾虑。高度害怕跌倒的患者比稍有顾虑的患者走得更慢,步长更短,支撑基础更宽,双支撑阶段延长。与稍有顾虑的多发性硬化症患者相比,恐惧患者的中心压力(CoP)轨迹的可变性也更高。多发性硬化症患者的跌倒恐惧和步态时空改变之间存在关联。此外,行走过程中 CoP 的可变性似乎与担忧程度有关。

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