Behrens Janina R, Mertens Sebastian, Krüger Theresa, Grobelny Anuschka, Otte Karen, Mansow-Model Sebastian, Gusho Elona, Paul Friedemann, Brandt Alexander U, Schmitz-Hübsch Tanja
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany/Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Mult Scler. 2016 Oct;22(12):1596-1606. doi: 10.1177/1352458515625807. Epub 2016 Jan 26.
Multiple sclerosis (MS) patients frequently have postural control impairment but quantitative posturography is difficult to perform in clinical care. Recent technology facilitates new posturography approaches.
To evaluate construct validity of visual perceptive computing (VPC) for static posturography to study postural control in MS patients.
A total of 90 MS patients and 59 healthy controls (HCs) performed three stance tests: open, closed and tandem stance. Static posturography was performed using a VPC system with Microsoft Kinect. Clinical assessments included Expanded Disability Status Scale (EDSS), Timed-25-Foot-Walk, Short-Maximum-Speed-Walk and 12-item MS Walking Scale (MSWS-12) questionnaire. Reliability was assessed with intra-class correlation coefficients at retest.
As a group, MS patients performed worse than HCs in all tests. The closed stance test showed best applicability and reliability. With closed eyes, in 36.7% of patients, the three-dimensional mean angular sway velocity (MSV-3D) was above HCs' 95th percentile. Higher MSV-3D was associated with decreased walking speed (p < 0.001); worse clinical scores, mainly attributable to the cerebellar functional system score (p < 0.001); and reflected in self-reported walking disability (MSWS-12, p < 0.001).
Postural control can be reliably assessed by VPC-based static posturography in patients with MS. Abnormal postural control seems to predominantly reflect involvement of cerebellar circuits with impact on gait and walking disability.
多发性硬化症(MS)患者经常存在姿势控制障碍,但在临床护理中难以进行定量姿势描记法检查。最新技术推动了新的姿势描记法检查方法的发展。
评估视觉感知计算(VPC)用于静态姿势描记法以研究MS患者姿势控制的结构效度。
90例MS患者和59名健康对照者(HCs)进行了三项站立测试:睁眼、闭眼和串联站立。使用配备微软Kinect的VPC系统进行静态姿势描记法检查。临床评估包括扩展残疾状态量表(EDSS)、25英尺定时步行、短距离最大速度步行和12项MS步行量表(MSWS-12)问卷。通过重测时的组内相关系数评估可靠性。
总体而言,MS患者在所有测试中的表现均比HCs差。闭眼站立测试显示出最佳的适用性和可靠性。闭眼时,36.7%的患者三维平均角摆动速度(MSV-3D)高于HCs的第95百分位数。较高的MSV-3D与步行速度降低相关(p<0.001);临床评分较差,主要归因于小脑功能系统评分(p<0.001);并反映在自我报告的步行残疾中(MSWS-12,p<0.001)。
基于VPC的静态姿势描记法可可靠地评估MS患者的姿势控制。异常的姿势控制似乎主要反映小脑回路受累,对步态和步行残疾有影响。