Pau Massimiliano, Corona Federica, Coghe Giancarlo, Marongiu Elisabetta, Loi Andrea, Crisafulli Antonio, Concu Alberto, Galli Manuela, Marrosu Maria Giovanna, Cocco Eleonora
a Department of Mechanical, Chemical and Materials Engineering , University of Cagliari , Cagliari , Italy.
b Department of Medical Sciences and Public Health , Multiple Sclerosis Center, University of Cagliari , Cagliari , Italy.
Disabil Rehabil. 2018 Jan;40(2):144-151. doi: 10.1080/09638288.2016.1244291. Epub 2017 Jan 13.
The purpose of this study is to quantitatively assess the effect of 6 months of supervised adapted physical activity (APA i.e. physical activity designed for people with special needs) on spatio-temporal and kinematic parameters of gait in persons with Multiple Sclerosis (pwMS).
Twenty-two pwMS with Expanded Disability Status Scale scores ranging from 1.5 to 5.5 were randomly assigned either to the intervention group (APA, n = 11) or the control group (CG, n = 11). The former underwent 6 months of APA consisting of 3 weekly 60-min sessions of aerobic and strength training, while CG participants were engaged in no structured PA program. Gait patterns were analyzed before and after the training using three-dimensional gait analysis by calculating spatio-temporal parameters and concise indexes of gait kinematics (Gait Profile Score - GPS and Gait Variable Score - GVS) as well as dynamic Range of Motion (ROM) of hip, knee, and ankle joints.
The training originated significant improvements in stride length, gait speed and cadence in the APA group, while GPS and GVS scores remained practically unchanged. A trend of improvement was also observed as regard the dynamic ROM of hip, knee, and ankle joints. No significant changes were observed in the CG for any of the parameters considered.
The quantitative analysis of gait supplied mixed evidence about the actual impact of 6 months of APA on pwMS. Although some improvements have been observed, the substantial constancy of kinematic patterns of gait suggests that the full transferability of the administered training on the ambulation function may require more specific exercises. Implications for rehabilitation Adapted Physical Activity (APA) is effective in improving spatio-temporal parameters of gait, but not kinematics, in people with multiple sclerosis. Dynamic range of motion during gait is increased after APA. The full transferability of APA on the ambulation function may require specific exercises rather than generic lower limbs strength/flexibility training.
本研究旨在定量评估为期6个月的有监督适应性体育活动（APA，即针对特殊需求人群设计的体育活动）对多发性硬化症患者（pwMS）步态的时空参数和运动学参数的影响。
22名扩展残疾状态量表评分在1.5至5.5之间的pwMS患者被随机分为干预组（APA，n = 11）或对照组（CG，n = 11）。前者接受为期6个月的APA，包括每周3次、每次60分钟的有氧和力量训练，而CG参与者未参加任何结构化体育活动计划。在训练前后，通过三维步态分析计算时空参数、步态运动学简明指标（步态轮廓评分 - GPS和步态变量评分 - GVS）以及髋、膝和踝关节的动态活动范围（ROM），对步态模式进行分析。
训练使APA组的步长、步态速度和步频有显著改善，而GPS和GVS评分基本保持不变。在髋、膝和踝关节的动态ROM方面也观察到改善趋势。CG组在所考虑的任何参数上均未观察到显著变化。
步态的定量分析为为期6个月的APA对pwMS的实际影响提供了混合证据。虽然观察到了一些改善，但步态运动学模式的基本不变表明，所实施的训练在步行功能上的完全可转移性可能需要更具体的练习。康复意义 适应性体育活动（APA）对改善多发性硬化症患者的步态时空参数有效，但对运动学无效。APA后步态期间的动态活动范围增加。APA在步行功能上的完全可转移性可能需要特定练习，而不是一般的下肢力量/柔韧性训练。
