Morel Eric, Allali Gilles, Laidet Magali, Assal Frédéric, Lalive Patrice H, Armand Stéphane
Willy Taillard Laboratory of Kinesiology, University Geneva Hospitals and Geneva University, Geneva, Switzerland.
Department of Clinical Neurosciences, Division of Neurology, University Geneva Hospitals, Geneva, Switzerland; Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, USA.
Gait Posture. 2017 Jan;51:169-173. doi: 10.1016/j.gaitpost.2016.10.013. Epub 2016 Oct 18.
Gait abnormalities are subtle in multiple sclerosis (MS) patients with low disability and need to be better determined. As a biomechanical approach, the Gait Profile Score (GPS) is used to assess gait quality by combining nine gait kinematic variables in one single value. This study aims i) to establish if the GPS can detect gait impairments and ii) to compare GPS with discrete spatiotemporal and kinematic parameters in low-disabled MS patients.
Thirty-four relapsing-remitting MS patients with an Expanded Disability Status Scale (EDSS) score ≤2 (mean age 36.32±8.72 years; 12 men, 22 women; mean EDSS 1.19±0.8) and twenty-two healthy controls (mean age 36.85±7.87 years; 6 men, 16 women) matched for age, weight, height, body mass index and gender underwent an instrumented gait analysis.
No significant difference in GPS values and in spatiotemporal parameters was found between patients and controls. However patients showed a significant alteration at the ankle and pelvis level.
GPS fails to identify gait abnormalities in low-disabled MS patients, although kinematic analysis revealed subtle gait alterations. Future studies should investigate other methods to assess gait impairments with a gait score in low-disabled MS patients.
在残疾程度较低的多发性硬化症（MS）患者中，步态异常较为细微，需要更好地加以判定。作为一种生物力学方法，步态轮廓评分（GPS）通过将九个步态运动学变量合并为一个单一值来评估步态质量。本研究旨在：i）确定GPS能否检测出步态损伤；ii）在残疾程度较低的MS患者中，将GPS与离散的时空参数和运动学参数进行比较。
34例复发缓解型MS患者，其扩展残疾状态量表（EDSS）评分≤2（平均年龄36.32±8.72岁；男性12例，女性22例；平均EDSS 1.19±0.8），以及22名年龄、体重、身高、体重指数和性别相匹配的健康对照者（平均年龄36.85±7.87岁；男性6例，女性16例）接受了仪器化步态分析。
患者与对照者之间在GPS值和时空参数方面未发现显著差异。然而，患者在踝关节和骨盆水平出现了显著改变。
尽管运动学分析显示存在细微的步态改变，但GPS未能识别出残疾程度较低的MS患者的步态异常。未来的研究应探索其他方法，以便用步态评分来评估残疾程度较低的MS患者的步态损伤。
