Gorgas Anna-Maria, Widener Gail L, Gibson-Horn Cynthia, Allen Diane D
Physical Therapy Program, St. Poelten University of Applied Sciences, St. Poelten, Austria.
Physiother Res Int. 2015 Mar;20(1):45-53. doi: 10.1002/pri.1595. Epub 2014 Jun 14.
People with multiple sclerosis (PwMS) commonly have mobility impairments that may lead to falls and limitations in activities. Physiotherapy interventions that might improve mobility typically take several weeks. Balance-based torso-weighting (BBTW), a system of strategically placing light weights to improve response to balance perturbations, has resulted in immediate small improvements in clinical measures in PwMS, but changes in spatiotemporal gait parameters are unknown. The purpose was to investigate the effects of BBTW on gait parameters in PwMS and healthy controls.
This study is a non-randomized controlled experiment.
This study included 20 PwMS and 20 matched healthy controls
People with multiple sclerosis walked on an instrumented mat at their fastest speed for three trials each in two conditions: without BBTW then with BBTW. Healthy controls walked in both conditions at two speeds: their fastest speed and at velocities equivalent to their matched PwMS.
Averaged gait trials showed that, with BBTW, PwMS had significantly increased velocity (p = 0.002), cadence (p = 0.007) and time spent in single-limb support (p = 0.014), with decreased time in double-limb support (p = 0.004). Healthy controls increased velocity (p = 0.012) and cadence (p = 0.015) and decreased support base (p = 0.014) in fast trials with BBTW; at matched velocities, step length (p = 0.028) and support base (p = 0.006) were significantly different from PwMS. All gait variables in healthy controls at fast speeds were significantly different from PwMS walking at their fastest speeds.
All participants showed increases in gait velocity and cadence during fast walk with BBTW. Improvements in time spent in single-limb and double-limb support by PwMS with BBTW may reflect greater stability in gait. Future research might ascertain if these immediate improvements could enhance effectiveness of longer-term physiotherapy on functional mobility in PwMS.
多发性硬化症患者(PwMS)通常存在行动障碍,这可能导致跌倒及活动受限。可能改善行动能力的物理治疗干预通常需要数周时间。基于平衡的躯干加权(BBTW)是一种通过策略性放置轻重量物体来改善对平衡扰动反应的系统,已使PwMS的临床指标立即得到小幅改善,但时空步态参数的变化尚不清楚。目的是研究BBTW对PwMS和健康对照者步态参数的影响。
本研究为非随机对照实验。
本研究纳入了20名PwMS患者和20名匹配的健康对照者。
多发性硬化症患者在装有仪器的垫子上以最快速度行走,在两种情况下各进行三次试验:不使用BBTW,然后使用BBTW。健康对照者在两种情况下以两种速度行走:他们的最快速度以及与匹配的PwMS患者相当的速度。
平均步态试验表明,使用BBTW时,PwMS患者的速度显著增加(p = 0.002)、步频显著增加(p = 0.007)以及单腿支撑时间显著增加(p = 0.014),双腿支撑时间减少(p = 0.004)。健康对照者在使用BBTW的快速试验中速度增加(p = 0.012)、步频增加(p = 0.015)且支撑面减小(p = 0.014);在匹配速度下,步长(p = 0.028)和支撑面(p = 0.006)与PwMS患者有显著差异。健康对照者快速行走时的所有步态变量与PwMS患者以最快速度行走时均有显著差异。
所有参与者在使用BBTW快速行走时步态速度和步频均增加。PwMS患者使用BBTW时单腿和双腿支撑时间的改善可能反映出步态更稳定。未来研究可能确定这些即时改善是否能增强长期物理治疗对PwMS患者功能性行动能力的有效性。