Hoang Phu D, Baysan Meryem, Gunn Hilary, Cameron Michelle, Freeman Jenny, Nitz Jennifer, Low Choy Nancy L, Lord Stephen R
Neuroscience Research Australia and University of New South Wales, Sydney Australia.
Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands.
Mult Scler J Exp Transl Clin. 2016 Apr 5;2:2055217316641130. doi: 10.1177/2055217316641130. eCollection 2016 Jan-Dec.
The Physiological Profile Assessment (PPA) is used in research and clinical practice for assessing fall risk. We compared PPA test performance between people with multiple sclerosis (MS) and healthy controls, determined the fall-risk profile for people with MS and developed a reference database for people with MS.
For this study, 416 ambulant people with MS (51.5 ± 12.0 years) and 352 controls (52.8 ± 12.2 years) underwent the PPA (tests of contrast sensitivity, proprioception, quadriceps strength, reaction time and sway) with composite fall-risk scores computed from these measures. MS participants were followed prospectively for falls for 3 months.
The MS participants performed significantly worse than controls in each PPA test. The average composite fall-risk score was also significantly elevated, indicating a "marked" fall risk when compared with controls. In total, 155 MS participants (37.3%) reported 2 + falls in the follow-up period. Frequent fallers performed significantly worse than non-frequent fallers in the contrast sensitivity, reaction time and sway tests and had higher PPA composite scores.
In line with poor PPA test performances, falls incidence in people with MS was high. This study provides comprehensive reference data for the PPA measures for people with MS that could be used to inform future research and clinical practice.
生理特征评估（PPA）用于研究和临床实践中评估跌倒风险。我们比较了多发性硬化症（MS）患者与健康对照者的PPA测试表现，确定了MS患者的跌倒风险特征，并为MS患者建立了参考数据库。
在本研究中，416名能够行走的MS患者（年龄51.5±12.0岁）和352名对照者（年龄52.8±12.2岁）接受了PPA测试（包括对比敏感度、本体感觉、股四头肌力量、反应时间和摇摆测试），并根据这些测量结果计算综合跌倒风险评分。对MS参与者进行了为期3个月的跌倒前瞻性随访。
在每项PPA测试中，MS参与者的表现均显著差于对照者。平均综合跌倒风险评分也显著升高，表明与对照者相比存在“明显”的跌倒风险。在随访期间，共有155名MS参与者（37.3%）报告发生了2次及以上跌倒。在对比敏感度、反应时间和摇摆测试中，频繁跌倒者的表现显著差于非频繁跌倒者，且PPA综合评分更高。
与PPA测试表现不佳一致，MS患者的跌倒发生率较高。本研究为MS患者的PPA测量提供了全面的参考数据，可用于指导未来的研究和临床实践。
