Kjølhede Tue, Vissing Kristian, Langeskov-Christensen Daniel, Stenager Egon, Petersen Thor, Dalgas Ulrik
Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark.
Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark.
Mult Scler Relat Disord. 2015 Mar;4(2):151-8. doi: 10.1016/j.msard.2015.01.002. Epub 2015 Jan 12.
Maximal muscle strength has been shown to be an important predictor of functional capacity for persons with multiple sclerosis (PwMS). Another muscle strength parameter known to be important for functional capacity in other patient groups is rate of force development (RFD) in knee extensors and flexors. This has not been investigated for PwMS. Thus, the purpose of this study was to investigate the relationship between RFD and maximal muscle strength of knee extensors and flexors and measures of functional capacity in PwMS.
35 PwMS (Expanded Disability Status Scale 2-4) underwent isokinetic dynamometry to determine RFD and maximal isometric and isokinetic muscle strength for both legs. Furthermore all participants performed timed 25 foot walk tests (T25FWT), two minute walk tests (2MWT), stairclimb tests and 5-time sit-to-stand (5STS) tests to determine functional capacity. Multiple linear regressions were performed to determine which muscle strength parameter would serve as a stronger predictor of walking performance.
Both RFD and maximal muscle strength correlated with functional capacity. Correlations were strongest for knee extensors and flexors of the weaker leg, while no clear ranking of the influence of the knee extensors vs. flexors on walking was evident. Multiple linear regressions showed that maximal isokinetic strength of the weaker leg is a better predictor for T25FWT and 2MWT performance than RFD.
Maximal muscle strength of the weaker leg is the better predictor of walking performance in persons with mild to moderate multiple sclerosis. RFD, although also important for functional capacity, is a less strong predictor. Maximal strength of the knee extensors, rather than the knee flexors, predicted performance in the stairclimb and 5STS tests.
最大肌肉力量已被证明是多发性硬化症患者（PwMS）功能能力的重要预测指标。另一个在其他患者群体中对功能能力很重要的肌肉力量参数是膝伸肌和屈肌的力量发展速率（RFD）。尚未对PwMS进行过此项研究。因此，本研究的目的是调查PwMS中RFD与膝伸肌和屈肌的最大肌肉力量以及功能能力指标之间的关系。
35名PwMS患者（扩展残疾状态量表2 - 4级）接受等速测力法，以确定双腿的RFD以及最大等长和等速肌肉力量。此外，所有参与者进行定时25英尺步行测试（T25FWT）、两分钟步行测试（2MWT）、爬楼梯测试和5次坐立测试（5STS）以确定功能能力。进行多元线性回归以确定哪个肌肉力量参数将作为步行性能的更强预测指标。
RFD和最大肌肉力量均与功能能力相关。较弱腿的膝伸肌和屈肌的相关性最强，而膝伸肌与屈肌对步行影响的明显排名并不明显。多元线性回归表明，较弱腿的最大等速力量比RFD更能预测T25FWT和2MWT性能。
在轻度至中度多发性硬化症患者中，较弱腿的最大肌肉力量是步行性能的更好预测指标。RFD虽然对功能能力也很重要，但预测能力较弱。膝伸肌的最大力量而非膝屈肌的最大力量可预测爬楼梯和5STS测试的性能。
