Klaren Rachel E, Pilutti Lara A, Sandroff Brian M, Motl Robert W
a Department of Kinesiology & Community Health , University of Illinois , 233 Freer Hall, Urbana , IL 61801 , USA.
Psychol Health Med. 2015;20(6):646-52. doi: 10.1080/13548506.2015.1026359. Epub 2015 Mar 27.
Persons with multiple sclerosis (MS) often demonstrate impairment in cardiorespiratory and musculoskeletal systems that may be associated with functional performance, functional limitations, and disability limitations. This study examined such relationships in persons with MS using Nagi's disablement model and its subsequent conceptual modifications. The sample included 63 persons with MS (75% relapsing-remitting MS, median EDSS = 4.0, and mean MS duration = 13.1 years) who underwent measurements of aerobic fitness and muscular strength (i.e. impairment), functional performance, functional limitations, and disability limitations. The data were primarily examined using path analysis in Mplus 7.0. Our final model provided an excellent fit for the data (χ² = 0.67, df = 3, p = 0.88, SRMR = 0.01, and CFI = 1.00). The final model indicated that aerobic fitness and muscular strength were indirectly associated with disability limitations in persons with MS through a pathway that included functional limitations (indirect path coefficients of 0.29 and 0.20, respectively), but not functional performance. Aerobic fitness and muscular strength may be the important targets of exercise training interventions for improving perceived functional limitations and disability limitations in persons with MS.
多发性硬化症（MS）患者常常表现出心肺和肌肉骨骼系统的损伤，这些损伤可能与功能表现、功能受限及残疾限制相关。本研究使用纳吉致残模型及其后续的概念修正，对MS患者中的此类关系进行了研究。样本包括63例MS患者（75%为复发缓解型MS，EDSS中位数 = 4.0，MS平均病程 = 13.1年），他们接受了有氧适能和肌肉力量（即损伤）、功能表现、功能受限及残疾限制的测量。数据主要在Mplus 7.0中使用路径分析进行检验。我们的最终模型对数据拟合良好（χ² = 0.67，自由度 = 3，p = 0.88，SRMR = 0.01，CFI = 1.00）。最终模型表明，有氧适能和肌肉力量通过一条包括功能受限的途径（间接路径系数分别为0.29和0.20）与MS患者的残疾限制间接相关，但与功能表现无关。有氧适能和肌肉力量可能是运动训练干预的重要目标，以改善MS患者的感知功能受限和残疾限制。
