Kreutzfeldt Melissa, Jensen Henrik B, Ravnborg Mads, Markvardsen Lars H, Andersen Henning, Sindrup Søren H
Department of Neurology, Odense University Hospital, Odense, Denmark.
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
J Peripher Nerv Syst. 2017 Jun;22(2):131-138. doi: 10.1111/jns.12210.
The aim of this study was to evaluate whether the six-spot-step test (SSST) is more suitable for monitoring walking ability in patients with chronic inflammatory polyneuropathy than the timed 25-foot-walking test (T25FW). In the SSST, participants have to walk as quickly as possible across a field measuring 1 × 5 m, while kicking blocks out of five circles on the floor. Sixty-two patients and 61 controls performed the SSST and T25FW. Patients also performed the overall disability sumscore, INCAT sensory sumscore, Medical Research Council sumscore, and 9-hole-peg-test. Twenty-one patients treated with intravenous immunoglobulin (IVIG) every 4-6 weeks were tested prior to and 2-3 weeks after treatment and judged change in their own clinical condition using the patient global impression of change (PGIC) scale. In patients, SSST ranged from 5.7 to 26.8 s and T25FW ranged from 3.6 to 12.9 s. Intra-class correlation between repeated tests was 0.97 for SSST and 0.95 for T25FW. Correlation with the additional tests was stronger for SSST than T25FW. In IVIG-treated patients, the mean change in walking time was -2.3 s for SSST and -0.6 s for T25FW. The SSST showed larger responsiveness in terms of effect size, standardized response means, and relative efficiency. Both ambulation tests correlated moderately to PGIC. The SSST may be superior to the T25FW in terms of dynamic range, floor effect, and responsiveness which makes the SSST a possible alternative for monitoring walking ability in patients with chronic inflammatory polyneuropathy.
本研究的目的是评估六点步测法（SSST）在监测慢性炎症性多发性神经病患者步行能力方面是否比25英尺定时步行测试（T25FW）更合适。在六点步测法中，参与者必须尽可能快地穿过一块1×5米的场地，同时将地板上五个圆圈中的障碍物踢开。62名患者和61名对照者进行了六点步测法和25英尺定时步行测试。患者还进行了整体残疾总分、INCAT感觉总分、医学研究理事会总分和九孔插板测试。21名每4 - 6周接受一次静脉注射免疫球蛋白（IVIG）治疗的患者在治疗前和治疗后2 - 3周进行了测试，并使用患者整体病情变化印象（PGIC）量表判断自身临床状况的变化。患者的六点步测法时间范围为5.7至26.8秒，25英尺定时步行测试时间范围为3.6至12.9秒。重复测试的组内相关性，六点步测法为0.97，25英尺定时步行测试为0.95。六点步测法与其他测试的相关性比25英尺定时步行测试更强。在接受IVIG治疗的患者中，六点步测法的步行时间平均变化为 - 2.3秒，25英尺定时步行测试为 - 0.6秒。在效应量、标准化反应均值和相对效率方面，六点步测法显示出更大的反应性。两种步行测试与PGIC均呈中度相关。在动态范围、地板效应和反应性方面，六点步测法可能优于25英尺定时步行测试，这使得六点步测法成为监测慢性炎症性多发性神经病患者步行能力的一种可能替代方法。
