Flansbjer Ulla-Britt, Lexell Jan, Brogårdh Christina
Department of Health Sciences, Lund University, Lund, Sweden.
Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
NeuroRehabilitation. 2017;41(2):403-411. doi: 10.3233/NRE-162057.
Reduced gait performance is common in persons with late effects of polio.
To identify predictors of change in gait performance over four years in persons with late effects of polio.
Gait performance was assessed annually in 51 ambulatory persons (mean age 64 years, SD 6) by the Timed "Up & Go" (TUG), Comfortable and Fast Gait Speed (CGS, FGS), and 6-Minute Walk Test (6MWT). Isokinetic knee extensor and flexor muscle strength was measured with a Biodex dynamometer. Mixed Linear Models were used to analyze changes in gait performance and to identify any predictors of change among the covariates gender, age, body mass index, time with new symptoms, baseline reduction in gait performance and knee muscle strength.
There were significant linear effects over time (reduction per year) for three gait performance tests; CGS (0.8%; p < 0.05), FGS (1.7%; p < 0.001), and 6MWT (0.7%; p < 0.05) with significant random effects for all tests. The strongest predictor of a change in gait performance was the individual variations in the knee flexor strength (p < 0.001).
The small gradual reduction in gait performance over time in persons with late effects of polio is primarily determined by the individual variations in the knee flexor strength.
步态功能减退在小儿麻痹后遗症患者中很常见。
确定小儿麻痹后遗症患者四年间步态功能变化的预测因素。
通过定时起立行走测试（TUG）、舒适步态速度（CGS）、快速步态速度（FGS）和6分钟步行试验（6MWT），每年对51名能行走的患者（平均年龄64岁，标准差6）的步态功能进行评估。使用Biodex测力计测量等速膝关节伸肌和屈肌力量。采用混合线性模型分析步态功能的变化，并确定协变量性别、年龄、体重指数、出现新症状的时间、步态功能的基线减退情况以及膝关节肌肉力量中变化的预测因素。
三项步态功能测试随时间（每年减退情况）均有显著线性效应；舒适步态速度（CGS）（0.8%；p<0.05）、快速步态速度（FGS）（1.7%；p<0.001）和6分钟步行试验（6MWT）（0.7%；p<0.05），所有测试均有显著随机效应。步态功能变化的最强预测因素是膝关节屈肌力量的个体差异（p<0.001）。
小儿麻痹后遗症患者步态功能随时间逐渐小幅减退主要由膝关节屈肌力量的个体差异决定。
