Draak Thomas H P, Gorson Kenneth C, Vanhoutte Els K, van Nes Sonja I, van Doorn Pieter A, Cornblath David R, van den Berg Leonard H, Faber Catharina G, Merkies Ingemar S J
Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands.
Department of Neurology, St. Elizabeth's Medical Centre, Tufts University School of Medicine, Boston, MA, USA.
J Peripher Nerv Syst. 2016 Jun;21(2):74-81. doi: 10.1111/jns.12167.
The "ability to walk" is considered a benchmark for good clinical recovery and prognosis, particularly in patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). However, it has never been determined whether being "able to walk" represents general functionality. The purpose of this study was to examine whether the ability to walk outside independently reflects general functional improvement in patients with GBS, CIDP, and gammopathy-related neuropathy (MGUSP). A total of 137 patients with newly diagnosed (or relapsing) GBS (55), CIDP (59), and MGUSP (23) were serially examined (1-year). Predefined arbitrary cut-offs (so-called patients' Functional-Acceptable-Clinical-Thresholds [FACTs]) were taken at the 50th, 75th, and 90th percentile of the Inflammatory-Rasch-built-Overall-Disability-Scale (I-RODS(©) ). We determined the proportion of patients able to walk outside independently that reached the postulated cut-offs. A mean total of 85%, 39%, and 12% of all patients able to walk reached 50th, 75th, and 90th percentile thresholds, respectively. These findings were not neuropathy type related. Our findings show that assessing only one construct of functionality (e.g., walking ability) does not reflect the full scope of daily/social functional deficits perceived by patients. The ability to walk shows a patient is doing better, but not necessarily doing well. The I-RODS(©) bypasses these limitations.
“行走能力”被视为临床良好恢复和预后的一项基准，在吉兰 - 巴雷综合征（GBS）和慢性炎症性脱髓鞘性多发性神经根神经病（CIDP）患者中尤为如此。然而，“能够行走”是否代表整体功能从未得到确定。本研究的目的是检验独立在户外行走的能力是否反映GBS、CIDP和丙种球蛋白病相关神经病（MGUSP）患者的整体功能改善。共有137例新诊断（或复发）的GBS患者（55例）、CIDP患者（59例）和MGUSP患者（23例）接受了为期1年的系列检查。在炎症性拉施构建的整体残疾量表（I - RODS(©)）的第50、75和90百分位数处采用预先定义的任意临界值（即所谓的患者功能可接受临床阈值[FACTs]）。我们确定了能够独立在户外行走并达到假定临界值的患者比例。所有能够行走的患者中，平均分别有85%、39%和12%达到了第50、75和90百分位数阈值。这些发现与神经病变类型无关。我们的研究结果表明，仅评估一种功能结构（如行走能力）并不能反映患者所感知的日常/社会功能缺陷的全貌。行走能力表明患者情况有所好转，但不一定良好。I - RODS(©)克服了这些局限性。
