Hasegawa T, Uchiyama Y, Uemura K, Harada Y, Sugiyama M, Tanaka H
1] Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Nagoya, Japan [2] Department of Rehabilitation Medicine, Chubu Rosai Hospital, Nagoya, Japan.
Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Spinal Cord. 2014 May;52(5):396-9. doi: 10.1038/sc.2014.18. Epub 2014 Mar 11.
Cross-sectional study.
To identify the physical impairments and walking function required for community ambulation in patients with cervical incomplete spinal cord injury (ISCI).
Chubu Rosai Hospital, Nagoya, Japan.
Forty patients with cervical ISCI (mean age: 49.9 years, American Spinal Injury Association Impairment Scale D) were included. The primary outcome measure was community ambulation based on Spinal Cord Independence Measure outdoor scores for a distance of >480 m. We measured the upper- and lower-extremity motor scores (UEMS and LEMS), sensory and spasticity. The walking tests included 10 m of walking at a comfortable- and maximum-walking speed (CWS and MWS; m s(-1)), 6 min walking test (6 MWT; m) and the walking index for spinal cord injury II (WISCI II). Multivariate logistic regression models were used to assess the physical impairments associated with community ambulation. Receiver operating characteristic curves were analyzed to determine the cutoff points for physical impairment and walking function.
The LEMS (beta coefficient (β)=0.71) and UEMS (β=0.41) were independently associated with community ambulation in patients with cervical ISCI. The cutoff points of the LEMS, UEMS, CWS, MWS, 6MWT and WISCI II were 41.5, 36.5, 1.00 m s(-1), 1.32 m s(-1), 472.5 m and 17.5, respectively, which suggests moderate to high accuracy.
The LEMS and UEMS were the most important factors affecting community ambulation in patients with cervical ISCI. The cutoff points of the walking function tests were highly accurate; therefore, these points can serve as targets for walking training in the future.
横断面研究。
确定颈髓不完全性脊髓损伤（ISCI）患者社区行走所需的身体损伤和行走功能。
日本名古屋中部罗赛医院。
纳入40例颈髓ISCI患者（平均年龄：49.9岁，美国脊髓损伤协会损伤分级D级）。主要结局指标是基于脊髓独立测量户外得分大于480米的社区行走能力。我们测量了上肢和下肢运动评分（UEMS和LEMS）、感觉和痉挛情况。行走测试包括以舒适和最大行走速度（CWS和MWS；米/秒）行走10米、6分钟步行测试（6MWT；米）以及脊髓损伤行走指数II（WISCI II）。采用多变量逻辑回归模型评估与社区行走相关的身体损伤。分析受试者工作特征曲线以确定身体损伤和行走功能的截断点。
LEMS（β系数（β）=0.71）和UEMS（β=0.41）与颈髓ISCI患者的社区行走独立相关。LEMS、UEMS、CWS、MWS、6MWT和WISCI II的截断点分别为41.5、36.5、1.00米/秒、1.32米/秒、472.5米和17.5，提示具有中到高度准确性。
LEMS和UEMS是影响颈髓ISCI患者社区行走的最重要因素。行走功能测试的截断点准确性高；因此，这些点可作为未来行走训练的目标。
