McLoughlin James, Barr Christopher, Crotty Maria, Lord Stephen R, Sturnieks Daina L
Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia (JM, CB, MC); and Neuroscience Research Australia (SRL, DLS) and School of Public Health and Community Medicine (JM, SRL, DLS), University of New South Wales, Sydney, New South Wales, Australia.
Int J MS Care. 2015 May-Jun;17(3):146-51. doi: 10.7224/1537-2073.2014-003.
The aims of this study were 1) to examine postural sway in the eyes open (EO) and eyes closed (EC) conditions in people with multiple sclerosis (MS) with moderate levels of disability compared with controls and 2) to examine relationships between postural sway and total Expanded Disability Status Scale (EDSS) scores, functional system subscores, and clinical measures of strength and spasticity in the MS group.
Thirty-four people with moderate MS and ten matched controls completed measures of postural sway with EO and EC, knee extension and ankle dorsiflexion isometric strength, EDSS total score and subscores, and spasticity levels.
Participants with MS swayed significantly more with EO and EC and had reduced knee extension and ankle dorsiflexion strength compared with controls (P < .001). In the MS group, increased sway was associated with higher total EDSS scores and cerebellar function subscores, whereas increased sway ratio (EC/EO) was associated with reduced sensory function subscores. Postural sway was not significantly associated with strength or spasticity.
Participants with MS swayed more and were significantly weaker than controls. Cerebellar dysfunction was identified as the EDSS domain most strongly associated with increased sway, and sensory loss was associated with a relatively greater dependence on vision for balance control. These findings suggest that exercise interventions targeting sensory integration and cerebellar ataxia may be beneficial for enhancing balance control in people with MS.
本研究的目的是：1）与对照组相比，检查中度残疾的多发性硬化症（MS）患者在睁眼（EO）和闭眼（EC）条件下的姿势晃动情况；2）检查MS组中姿势晃动与扩展残疾状态量表（EDSS）总分、功能系统子分数以及力量和痉挛的临床测量指标之间的关系。
34名中度MS患者和10名匹配的对照组完成了EO和EC条件下的姿势晃动测量、膝关节伸展和踝关节背屈等长力量测量、EDSS总分和子分数测量以及痉挛水平测量。
与对照组相比，MS患者在EO和EC条件下的晃动明显更多，膝关节伸展和踝关节背屈力量降低（P <.001）。在MS组中，晃动增加与较高的EDSS总分和小脑功能子分数相关，而晃动比率增加（EC/EO）与感觉功能子分数降低相关。姿势晃动与力量或痉挛无显著相关性。
MS患者比对照组晃动更多且明显更虚弱。小脑功能障碍被确定为与晃动增加最密切相关的EDSS领域，感觉丧失与平衡控制对视觉的相对更大依赖相关。这些发现表明，针对感觉整合和小脑共济失调的运动干预可能有助于增强MS患者的平衡控制。
