Pau Massimiliano, Coghe Giancarlo, Atzeni Claudia, Corona Federica, Pilloni Giuseppina, Marrosu Maria Giovanna, Cocco Eleonora, Galli Manuela
Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy.
Centro Sclerosi Multipla, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
J Neurol Sci. 2014 Oct 15;345(1-2):159-63. doi: 10.1016/j.jns.2014.07.032. Epub 2014 Jul 19.
The assessment of gait abnormalities in individuals with multiple sclerosis (MS) represents a key factor in evaluating the effectiveness of rehabilitation treatments. Despite the availability of sophisticated equipment to objectively evaluate the kinematic aspects of gait, there are still some difficulties in processing the large and complex amount of data they produce in the daily clinical routine. On the basis of the above-mentioned considerations we propose a novel characterization of gait kinematics in individuals with MS, based on a single measure (gait profile score, GPS) obtained from a quantitative three-dimensional analysis of gait performed using an opto-electronic system. We also investigated the correlation between GPS and the Expanded Disability Status Scale (EDSS) values. Thirty-four patients suffering from relapsing-remitting MS (13 female, 21 male, mean age 46.7 years) with an EDSS score of ≤6 underwent a gait analysis from which the GPS index was calculated. Their results were compared with those of a control group of healthy age- and gender-matched subjects. The GPS of individuals with MS was found significantly higher with respect to controls (9.12° vs. 5.67°, p<0.001) as the result of kinematic differences in gait patterns referring to pelvic tilt and rotation, hip flexion-extension and rotation, knee flexion-extension and ankle dorsi- and plantar-flexion. A moderate correlation was also found between the EDSS score of the participants and their GPS values (r = 0.63, p < 0.001). The GPS index thus appears suitable to represent gait deviations from physiological patterns in individuals affected by MS and potentially useful in assessing the outcomes related both to rehabilitation programs and pharmacologic/physical therapies.
评估多发性硬化症(MS)患者的步态异常是评估康复治疗效果的关键因素。尽管有先进的设备可客观评估步态的运动学方面,但在日常临床工作中处理这些设备产生的大量复杂数据仍存在一些困难。基于上述考虑,我们提出了一种针对MS患者步态运动学的新特征描述,该描述基于通过使用光电系统对步态进行定量三维分析获得的单一测量值(步态轮廓评分,GPS)。我们还研究了GPS与扩展残疾状态量表(EDSS)值之间的相关性。34例复发缓解型MS患者(13例女性,21例男性,平均年龄46.7岁),EDSS评分≤6,接受了步态分析并计算了GPS指数。将他们的结果与年龄和性别匹配的健康对照组的结果进行比较。由于在骨盆倾斜和旋转、髋关节屈伸和旋转、膝关节屈伸以及踝关节背屈和跖屈等步态模式上存在运动学差异,发现MS患者的GPS明显高于对照组(9.12°对5.67°,p<0.001)。参与者的EDSS评分与其GPS值之间也发现了中度相关性(r = 0.63,p < 0.001)。因此,GPS指数似乎适合代表受MS影响个体的步态与生理模式的偏差,并且可能有助于评估与康复计划以及药物/物理治疗相关的结果。