Cattaneo Davide, Rabuffetti Marco, Bovi Gabriele, Mevio Elisabetta, Jonsdottir Johanna, Ferrarin Maurizio
Department of Neurorehabilitation, LaRiCE: Gait and Balance Disorders Laboratory, Don Gnocchi Foundation I.R.C.C.S.V. , Capecelatro, Milano , Italy and.
Disabil Rehabil. 2014;36(26):2237-43. doi: 10.3109/09638288.2014.904933. Epub 2014 Mar 29.
In accordance with the Task Oriented Approach, clinicians need assessment procedures providing information on the execution of multiple tasks. Instrumented task assessment can add information regarding sensory-motor strategies, difficult to assess purely by clinical observation. It has been shown that People with Multiple Sclerosis (PwMS) have difficulties in maintaining upright balance, but little is known about their ability to achieve a stable posture after the execution of tasks related to activities of daily living. The aim of the present study was to assess postural stabilization in a population of PwMS.
Twenty Healthy Subjects (HS) and twenty PwMS were assessed in three tasks leading to a quiet erect posture: sit-to-stand, taking a step forward, bending forward. Antero-posterior ground reaction force was measured by a force platform and interpolated by a model providing information on the initial instability after task execution (Transitional_Sway), the time required to dissipate this initial instability (Stabilization_Time), and their stability in quiet upright posture (Static_Sway).
PwMS had statistically significant altered performance in comparison to HS: their instability after task execution (Transitional_Sway) was higher in bending and sit-to-stand (p < 0.05), their stabilization time (Stabilization_Time) was longer in bending and step forward (p < 0.05). Static_Sway was higher in all tasks (p < 0.05) indicating imbalance also in quiet upright posture.
根据任务导向法,临床医生需要评估程序来提供有关多项任务执行情况的信息。仪器辅助任务评估可以补充有关感觉运动策略的信息,而这些信息很难仅通过临床观察来评估。研究表明,多发性硬化症患者(PwMS)在维持直立平衡方面存在困难,但对于他们在执行与日常生活活动相关的任务后实现稳定姿势的能力知之甚少。本研究的目的是评估PwMS人群的姿势稳定性。
对20名健康受试者(HS)和20名PwMS进行三项任务评估,这些任务可导致安静的直立姿势:从坐到站、向前迈一步、向前弯腰。通过力平台测量前后地面反作用力,并通过一个模型进行插值,该模型提供有关任务执行后初始不稳定性(过渡性摆动)、消散这种初始不稳定性所需的时间(稳定时间)以及他们在安静直立姿势下的稳定性(静态摆动)的信息。
与HS相比,PwMS的表现有统计学上的显著改变:他们在弯腰和从坐到站时任务执行后的不稳定性(过渡性摆动)更高(p < 0.05),在弯腰和向前迈步时稳定时间(稳定时间)更长(p < 0.05)。在所有任务中,静态摆动都更高(p < 0.05),表明在安静直立姿势下也存在不平衡。