Bozgeyik Sibel, Alemdaroğlu İpek, Bulut Numan, Yılmaz Öznur, Karaduman Ayşe
Hacettepe University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Ankara, Turkey.
Eur J Paediatr Neurol. 2017 May;21(3):494-499. doi: 10.1016/j.ejpn.2016.12.008. Epub 2016 Dec 22.
The aim of this study was to investigate the relationship between neck flexor muscle strength and functional performance in children with DMD.
A total of 70 children with DMD between Level 1 and 3 according to Brooke Lower Extremity Functional Classification (BLEFC) were included in the study. Children were divided into 2 groups according to neck flexor strength measured by Medical Research Council Scale as Group 1 (3⁻ and below) and Group 2 (3 and above). Functional performance was assessed by 6 Minute Walk Distance (6MWD) and timed performance tests, and ambulatory status by North Star Ambulatory Assessment (NSAA). Correlations between neck flexor strength and performance tests were analyzed by using Spearman's correlation coefficient in non-parametric conditions.
Thirty-six and 34 children were included in Group 1 and 2, respectively. No statistically significant difference was found in BLEFC between groups (z = -1.225, p > 0.05). 6MWD (z = -2.574, p = 0.01) was found to be longer and NSAA (z = -2.565, p = 0.01) was higher in Group 2. Positive, moderate, statistically significant correlations were determined between neck flexor muscle strength and 6MWD (p < 0.01, r = 0.374); NSAA (p < 0.01, r = 0.399) while a negative, weak correlation between neck flexor muscle strength and the duration for standing from supine position (p = 0.02, r = -0.290).
The results indicate the relationship of neck flexor muscle strength and functional performance in DMD children. It is thought that the approaches to maintain neck flexor muscle strength from the early stages of disease process may support functional activities of daily life with less compensation and effort in DMD.
本研究旨在探讨杜氏肌营养不良症（DMD）患儿颈部屈肌力量与功能表现之间的关系。
根据布鲁克下肢功能分级（BLEFC），共纳入70例1至3级的DMD患儿。根据医学研究委员会量表测量的颈部屈肌力量，将患儿分为两组，第1组（3⁻及以下）和第2组（3及以上）。通过6分钟步行距离（6MWD）和定时性能测试评估功能表现，通过北极星动态评估（NSAA）评估行走状态。在非参数条件下，使用Spearman相关系数分析颈部屈肌力量与性能测试之间的相关性。
第1组和第2组分别纳入36例和34例患儿。两组之间在BLEFC上未发现统计学显著差异（z = -1.225，p > 0.05）。发现第2组的6MWD（z = -2.574，p = 0.01）更长，NSAA（z = -2.565，p = 0.01）更高。确定颈部屈肌力量与6MWD（p < 0.01，r = 0.374）；NSAA（p < 0.01，r = 0.399）之间存在正的、中等的、统计学显著的相关性，而颈部屈肌力量与从仰卧位站立的持续时间之间存在负的、弱的相关性（p = 0.02，r = -0.290）。
结果表明DMD患儿颈部屈肌力量与功能表现之间的关系。认为从疾病过程的早期阶段开始维持颈部屈肌力量的方法可能以较少的代偿和努力支持DMD患儿的日常生活功能活动。
