Davenport Todd E, Benson Kimberly, Baker Stephanie, Gracey Christopher, Rakocevic Goran, McElroy Beverly, Dalakas Marinos, Shrader Joseph A, Harris-Love Michael O
University of the Pacific Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California.
Arthritis Care Res (Hoboken). 2015 Jan;67(1):94-101. doi: 10.1002/acr.22468.
To determine the relationship between peak isometric muscle force and temporal characteristics of gait in individuals with sporadic inclusion body myositis (s-IBM).
An observational study of 42 individuals with s-IBM (12 women; mean ± SD age 61.8 ± 7.3 years and mean ± SD disease duration 8.9 ± 4.3 years) was conducted at a federal hospital. Peak isometric force measurements for lower extremity (LE) muscle groups were obtained using quantitative muscle testing. Temporal characteristics of gait during habitual and fast walking conditions were measured using a portable gait analysis system.
All observed muscle force values were significantly lower than predicted values (P ≤ 0.001). During habitual walking, the subjects' gait speed and cadence were ≤83% of normative literature values. During fast walking, total gait cycle time was 133% of normal, while gait speed and cadence were 58% and 78% of normative literature values, respectively. Scaled LE peak muscle forces showed significant moderate correlations with temporal gait variables. Weaker subjects had greater limitations in gait speed and cadence compared with stronger subjects (P < 0.05). Peak isometric force of the knee flexors and ankle plantar flexors was significantly correlated with most temporal features of habitual gait.
Muscle weakness associated with s-IBM disease activity may contribute to diminished gait kinematics. Temporal features of gait were not substantially influenced by knee extensor weakness alone, considering the knee flexors and ankle plantar flexors played a compensatory role in maintaining the walking ability of individuals with s-IBM.
确定散发性包涵体肌炎(s-IBM)患者等长肌肉力量峰值与步态时间特征之间的关系。
在一家联邦医院对42例s-IBM患者(12名女性;平均±标准差年龄61.8±7.3岁,平均±标准差病程8.9±4.3年)进行了一项观察性研究。使用定量肌肉测试获得下肢(LE)肌肉群的等长力量峰值测量值。使用便携式步态分析系统测量习惯性和快速行走条件下的步态时间特征。
所有观察到的肌肉力量值均显著低于预测值(P≤0.001)。在习惯性行走期间,受试者的步态速度和步频≤正常文献值的83%。在快速行走期间,总步态周期时间为正常的133%,而步态速度和步频分别为正常文献值的58%和78%。标准化的LE肌肉力量峰值与步态时间变量呈显著的中度相关性。与较强的受试者相比,较弱的受试者在步态速度和步频方面有更大的限制(P<0.05)。膝屈肌和踝跖屈肌的等长力量峰值与习惯性步态的大多数时间特征显著相关。
与s-IBM疾病活动相关的肌肉无力可能导致步态运动学减弱。考虑到膝屈肌和踝跖屈肌在维持s-IBM患者行走能力方面起补偿作用,步态的时间特征并未仅受膝伸肌无力的显著影响。