Sebastião Emerson, Learmonth Yvonne C, Motl Robert W
From the Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois.
Am J Phys Med Rehabil. 2017 May;96(5):357-361. doi: 10.1097/PHM.0000000000000581.
Persons with multiple sclerosis (MS) often report being afraid of falling, and this may have effects on physical activity (PA) engagement. This study investigated PA levels in persons with MS as a function of fall risk categories. Forty-seven persons with MS participated in the study and were categorized into either increased fall risk (IFR; n = 21; 55.5 ± 9.0 years) or normal fall risk (NFR; n = 26; 51.2 ± 12.9 years) groups based on scores from the Activities-Balance Confidence scale. PA was measured by accelerometer and expressed as average steps per day, and time spent in sedentary behavior, light PA, and moderate to vigorous physical activity over the course of 7 consecutive days. Univariate and covariate analyses were used to compare the differences in PA between fall risk groups. The average steps per day of the NFR group was significant higher compared with the IFR group (6024 ± 2533.1 vs. 2599 ± 1622.7 steps; P < 0.001), and the difference remained after controlling for disability level (5351 ± 2298.6 vs. 3432 ± 2363.6 steps; P = 0.016). There were no differences in light PA and moderate to vigorous physical activity between groups after controlling for disability level. Persons with MS at IFR accumulate fewer steps per day compared with those at NFR. This underscores the need for well-designed interventions targeting walking in this population who are far from the recommended 10,000 steps, particularly those with IFR.
多发性硬化症（MS）患者经常表示害怕摔倒，这可能会对身体活动（PA）参与度产生影响。本研究调查了MS患者的PA水平与跌倒风险类别的关系。47名MS患者参与了该研究，并根据活动平衡信心量表的得分被分为跌倒风险增加组（IFR；n = 21；55.5±9.0岁）或正常跌倒风险组（NFR；n = 26；51.2±12.9岁）。通过加速度计测量PA，并表示为连续7天内每天的平均步数，以及久坐行为、轻度PA和中度至剧烈身体活动所花费的时间。采用单因素和协变量分析来比较跌倒风险组之间PA的差异。NFR组的每日平均步数显著高于IFR组（6024±2533.1步对2599±1622.7步；P < 0.001），在控制残疾水平后差异仍然存在（5351±2298.6步对3432±2363.6步；P = 0.016）。在控制残疾水平后，两组之间的轻度PA和中度至剧烈身体活动没有差异。与NFR组相比，IFR组的MS患者每天积累的步数更少。这凸显了针对该人群步行设计精心干预措施的必要性，这些人群远未达到推荐的10000步，尤其是那些IFR患者。
