Zackowski Kathleen M, Wang Joseph I, McGready John, Calabresi Peter A, Newsome Scott D
Mult Scler Relat Disord. 2015 Jan;4(1):67-74. doi: 10.1016/j.msard.2014.11.001.
Impairments of sensation, strength, and walking are common in multiple sclerosis (MS). The relationship among these abnormalities and how they change over time remains unclear.
To determine the extent that quantitative lower extremity sensory and motor measures detect abnormalities over time, relate to global disability, and to walking speed in individuals with MS.
This prospective, longitudinal analysis evaluated 136 MS subjects. Measures included measures of leg strength, sensation, the Expanded Disability Status Scale(EDSS) and timed 25-foot walk test (T25FW). Mixed effects regression models were used.
Our cohort׳s mean age is 44.3±10.8 years (mean±SD), EDSS score range 0–7.5, 66% were females, and follow-up time was 2.1±1.2 years. Strength significantly changed over time; the RRMS group demonstrated the greatest changes in ADF (3.3 lbs/yr) while the PPMS group showed significant HF changes (−2.1 lbs/yr). Walking speed was affected most by HF, especially in the weakest individuals (HF<20 lbs); T25FW increased by 0.20 s for each 1 lb loss (p=0.001). Likewise T25FW changed by 0.19 s for each 1 lb change in ADF (p<0.01).
Quantitative measures detected changes in sensation and strength over time, despite a stable respective functional systems scores of the EDSS. Quantitative measurement tools may improve the sensitivity of disability measures in MS and further investigation of these tools as outcomes in future clinical trials of rehabilitative and neuroreparative interventions is warranted.
感觉、力量和行走功能障碍在多发性硬化症(MS)中很常见。这些异常之间的关系以及它们如何随时间变化仍不清楚。
确定定量的下肢感觉和运动测量方法随时间检测异常的程度、与整体残疾的关系以及与MS患者步行速度的关系。
这项前瞻性纵向分析评估了136名MS患者。测量指标包括腿部力量、感觉、扩展残疾状态量表(EDSS)和25英尺定时步行测试(T25FW)。使用混合效应回归模型。
我们队列的平均年龄为44.3±10.8岁(平均值±标准差),EDSS评分范围为0 - 7.5,66%为女性,随访时间为2.1±1.2年。力量随时间有显著变化;复发缓解型MS(RRMS)组在踝背屈力(ADF)方面变化最大(每年3.3磅),而原发进展型MS(PPMS)组在髋伸肌力量(HF)方面有显著变化(每年 - 2.1磅)。步行速度受HF影响最大,尤其是在最弱的个体中(HF<20磅);每减少1磅HF,T25FW增加0.20秒(p = 0.001)。同样,每变化1磅ADF,T25FW变化0.19秒(p<0.01)。
尽管EDSS的相应功能系统评分稳定,但定量测量方法仍能检测到感觉和力量随时间的变化。定量测量工具可能会提高MS中残疾测量的敏感性,因此有必要在未来的康复和神经修复干预临床试验中进一步研究将这些工具作为结果指标。