Allali Gilles, Laidet Magali, Armand Stéphane, Elsworth-Edelsten Charlotte, Assal Frédéric, Lalive Patrice H
Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, USA.
J Neural Transm (Vienna). 2016 Jun;123(6):595-9. doi: 10.1007/s00702-016-1551-4. Epub 2016 Apr 22.
Fear of falling (FOF) and gait disorders represent both prevalent symptoms in patients with multiple sclerosis (MS); however, the association between FOF and higher level of gait control (HLGC) has not been studied in MS. This study aims to assess the association between FOF and HLGC in patients with MS. HLGC was assessed by stride time variability (STV) during single and dual-tasks (forward counting, backward counting, categorical verbal fluency and literal verbal fluency) and FOF was quantified by the falls efficacy scale-international (FES-I). Seventy-one patients (age: 39.27 ± 9.77 years; 63 % female) were included in this cross-sectional study (Expanded Disability Status Scale (median): 2.00) with a low prevalence of FOF (FES-I: 21.52 ± 8.37). The mean gait speed was 1.19 ± 0.23 m/s with a STV of 2.35 ± 1.68 % during single walking task. STV during single task and the dual tasks of forward counting and backward counting were associated with the FES-I in the univariable linear regression models (p ≤ 0.001), but only STV while backward counting (β: 0.42, [0.18;0.66]) was associated with FOF in the multivariable model (adjusted for age, gender, previous fall, Expanded Disability Status Scale and gait speed). These findings indicate that FOF is associated with STV while backward counting, a marker of HLGC in relationship with working memory in a MS population including a majority of low disabled patients.
害怕跌倒（FOF）和步态障碍是多发性硬化症（MS）患者中都普遍存在的症状；然而，MS患者中FOF与更高水平步态控制（HLGC）之间的关联尚未得到研究。本研究旨在评估MS患者中FOF与HLGC之间的关联。通过单任务和双任务（顺数、倒数、分类语言流畅性和逐字语言流畅性）期间的步幅时间变异性（STV）来评估HLGC，并用国际跌倒效能量表（FES-I）对FOF进行量化。本横断面研究纳入了71例患者（年龄：39.27±9.77岁；63%为女性）（扩展残疾状态量表（中位数）：2.00），FOF患病率较低（FES-I：21.52±8.37）。单步行任务期间的平均步态速度为1.19±0.23米/秒，STV为2.35±1.68%。在单变量线性回归模型中，单任务以及顺数和倒数双任务期间的STV与FES-I相关（p≤0.001），但在多变量模型中（对年龄、性别、既往跌倒史、扩展残疾状态量表和步态速度进行校正），仅倒数时的STV（β：0.42，[0.18；0.66]）与FOF相关。这些发现表明，在包括大多数轻度残疾患者的MS人群中，FOF与倒数时的STV相关，STV是与工作记忆相关的HLGC的一个指标。
