Coghe G, Pau M, Corona F, Frau J, Lorefice L, Fenu G, Spinicci G, Mamusa E, Musu L, Massole S, Massa R, Marrosu M G, Cocco E
Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy.
J Neurol. 2015 Nov;262(11):2472-7. doi: 10.1007/s00415-015-7866-5. Epub 2015 Aug 5.
Recently, nabiximols was approved as a treatment in MS spasticity. Data leading to approval and clinical use of nabiximols, although widely recognised, are based on subjective scales. Movement analysis procedures would obtain more detailed data about the impact on mobility. The aim of the study was to quantitatively assess the functional modification of gait patterns induced by nabiximols in MS. We evaluated three-dimensional gait analysis (spatial-temporal and kinematic) variation by means of one-way ANOVA. Twenty patients were enrolled-9 male and 11 female-with mean EDSS of 5.3 (SD ± 0.81) and mean reduction of numerical rating scale during nabiximols treatment of 1.88. The spatial-temporal parameters of gait revealed an increased speed (+15 %, p < 0.001), cadence (+6 %, p < 0.001) and stride length (+10 %, p < 0.001) after treatment. Regarding the kinematics data, the Gait Profile Score after treatment was reduced by 10 % (p < 0.001): Significant changes involved the pelvic area, hip rotation and knee flexion-extension. We found that nabiximols is able to improve the speed, cadence and stride length. Furthermore, the dynamics of the proximal segment of the legs and the knee movement results after treatment are closer to the physiologic values.
最近，纳比西莫尔被批准用于治疗多发性硬化症痉挛。导致纳比西莫尔获批及临床应用的数据虽广为人知，但基于主观量表。运动分析程序将获取有关其对活动能力影响的更详细数据。本研究的目的是定量评估纳比西莫尔对多发性硬化症患者步态模式的功能改变。我们通过单因素方差分析评估三维步态分析（时空和运动学）变化。纳入了20名患者，其中9名男性和11名女性，平均扩展残疾状态量表（EDSS）评分为5.3（标准差±0.81），在纳比西莫尔治疗期间数字评定量表平均降低了1.88。步态的时空参数显示，治疗后速度增加了15%（p<0.001）、步频增加了6%（p<0.001）、步长增加了10%（p<0.001）。关于运动学数据，治疗后的步态轮廓评分降低了10%（p<0.001）：显著变化涉及骨盆区域、髋关节旋转和膝关节屈伸。我们发现纳比西莫尔能够提高速度、步频和步长。此外，治疗后腿部近端节段的动力学和膝关节运动结果更接近生理值。
