Feys P, Bibby B M, Baert I, Dalgas U
REVAL, University of Hasselt, REVAL/BIOMED, Diepenbeek, Belgium -
Eur J Phys Rehabil Med. 2015 Apr;51(2):207-10. Epub 2014 Sep 2.
Patients with progressive multiple sclerosis (MS) have been attributed greater walking disability than relapsing-remitting MS (RRMS) patients but quantitative data on walking speed and ability are lacking.
To investigate the impact of type of MS on severity of reduced walking ability and capacity taking into account age, sex, height and disease duration.
Cross-sectional observational multi-center study
European MS centers providing either in- or out-patient services, or both.
This study included 502 patients: 259, 162 and 81 patients showed RRMS, secondary and primary progressive MS respectively.
Walking was evaluated by T25FW, six minute walk test and MS-Walking Scale-12. Patient characteristics were compared using a one-way ANOVA, and simple and multivariate regression analysis were applied with the walking measures.
In adjusted (sex, age, weight, height and disease duration) analyses, walking impairments were more than 20% greater in progressive types of MS compared to RRMS. There were also indications of greater walking impairment in primary compared to secondary progressive MS patients.
Clinical walking impairment was larger in progressive compared to relapsing-remitting type of MS. The biological disease mechanism, being degeneration or inflammation, impacts on disability.
Health care professionals must be aware of different severity of walking impairment in progressive compared to relapsing type of MS, and need for intensive treatment. Also, studies must report rehabiltiation effects according to MS type.
进展型多发性硬化症(MS)患者的行走残疾程度被认为比复发缓解型MS(RRMS)患者更严重,但缺乏关于步行速度和能力的定量数据。
在考虑年龄、性别、身高和病程的情况下,研究MS类型对步行能力和容量降低的严重程度的影响。
横断面观察性多中心研究
提供门诊或住院服务或两者皆有的欧洲MS中心。
本研究纳入了502例患者:分别有259例、162例和81例患者表现为RRMS、继发进展型MS和原发进展型MS。
通过25英尺步行时间(T25FW)、6分钟步行试验和MS步行量表-12评估步行情况。使用单因素方差分析比较患者特征,并对步行指标进行简单和多因素回归分析。
在调整(性别、年龄、体重、身高和病程)分析中,与RRMS相比,进展型MS的步行障碍多出20%以上。也有迹象表明,与继发进展型MS患者相比,原发进展型MS患者的步行障碍更大。
与复发缓解型MS相比,进展型MS的临床步行障碍更大。生物性疾病机制,无论是退化还是炎症,都会影响残疾程度。
医疗保健专业人员必须意识到进展型MS与复发型MS在步行障碍严重程度上的差异,以及强化治疗的必要性。此外,研究必须根据MS类型报告康复效果。