Severini Giacomo, Manca Mario, Ferraresi Giovanni, Caniatti Luisa Maria, Cosma Michela, Baldasso Francesco, Straudi Sofia, Morelli Monica, Basaglia Nino
School of Electrical and Electronic Engineering, University College Dublin, Dublin, Ireland.
Neuroscience and Rehabilitation Department, Ferrara University Hospital, Via della Fiera, 44100 Ferrara, Italy.
Clin Biomech (Bristol). 2017 Jun;45:1-8. doi: 10.1016/j.clinbiomech.2017.04.001. Epub 2017 Apr 3.
Clinical Gait Analysis is commonly used to evaluate specific gait characteristics of patients affected by Multiple Sclerosis. The aim of this report is to present a retrospective cross-sectional analysis of the changes in Clinical Gait Analysis parameters in patients affected by Multiple Sclerosis.
In this study a sample of 51 patients with different levels of disability (Expanded Disability Status Scale 2-6.5) was analyzed. We extracted a set of 52 parameters from the Clinical Gait Analysis of each patient and used statistical analysis and linear regression to assess differences among several groups of subjects stratified according to the Expanded Disability Status Scale and 6-Minutes Walking Test. The impact of assistive devices (e.g. canes and crutches) on the kinematics was also assessed in a subsample of patients.
Subjects showed decreased range of motion at hip, knee and ankle that translated in increased pelvic tilt and hiking. Comparison between the two stratifications showed that gait speed during 6-Minutes Walking Test is better at discriminating patients' kinematics with respect to Expanded Disability Status Scale. Assistive devices were shown not to significantly impact gait kinematics and the Clinical Gait Analysis parameters analyzed.
We were able to characterize disability-related trends in gait kinematics. The results presented in this report provide a small atlas of the changes in gait characteristics associated with different disability levels in the Multiple Sclerosis population. This information could be used to effectively track the progression of MS and the effect of different therapies.
临床步态分析常用于评估受多发性硬化症影响患者的特定步态特征。本报告的目的是对受多发性硬化症影响患者的临床步态分析参数变化进行回顾性横断面分析。
在本研究中，分析了51名具有不同残疾水平（扩展残疾状态量表2 - 6.5）的患者样本。我们从每位患者的临床步态分析中提取了一组52个参数，并使用统计分析和线性回归来评估根据扩展残疾状态量表和6分钟步行试验分层的几组受试者之间的差异。还在一部分患者子样本中评估了辅助设备（如手杖和拐杖）对运动学的影响。
受试者的髋、膝和踝关节活动范围减小，表现为骨盆倾斜增加和提髋。两种分层之间的比较表明，6分钟步行试验期间的步态速度在区分患者运动学方面比扩展残疾状态量表更好。结果显示辅助设备对步态运动学和所分析的临床步态分析参数没有显著影响。
我们能够描述步态运动学中与残疾相关的趋势。本报告中呈现的结果提供了一个关于多发性硬化症患者群体中与不同残疾水平相关的步态特征变化的小型图谱。这些信息可用于有效跟踪多发性硬化症的进展以及不同疗法的效果。
