Kalron Alon, Achiron Anat, Menascu Shay
1 Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
2 Sagol School of Neurosciences, Tel-Aviv University, Tel-Aviv, Israel.
J Child Neurol. 2019 Jan;34(1):27-32. doi: 10.1177/0883073818808034. Epub 2018 Oct 25.
Gait variability is associated with cognitive performance in people with central neurologic damage illnesses, which includes multiple sclerosis. However, presently, there have been no data available as to whether this association exists in adolescents with multiple sclerosis. Therefore, our objective was to investigate the association between gait variability and cognition in adolescents with multiple sclerosis encompassing 48 recently diagnosed adolescents with multiple sclerosis (26 girls; 22 boys), average age of 16.0 years (SD = 2.2), and an Expanded Disability Status Scale (EDSS) score of 1.6 (SD = 1.3). Walking speed and gait variability expressed by the coefficient of variation of the mean step time was studied using an electronic walkway. A computerized cognitive battery of tests evaluated cognition. Cognitive outcome measurements included verbal and nonverbal memory, executive function, visual spatial processing, verbal function, attention, information processing speed, and motor skills. Mean walking speed was 76.9 cm/s (SD = 57.6); mean step time variability was 3.5 (SD = 1.3) and the global cognitive score was 93.9 (SD = 12.5). According to linear regression analysis, a significant association was found between step time variability, cognitive subdomains of attention, and information processing speed. After incorporating walking speed into the model, the association remained significant. Increased gait variability, not walking speed, is suggested as a clinical marker of cognitive performance in minimally disabled adolescents with multiple sclerosis.
步态变异性与患有中枢神经损伤疾病（包括多发性硬化症）的人的认知表现相关。然而，目前尚无关于这种关联是否存在于患有多发性硬化症的青少年中的数据。因此，我们的目标是研究患有多发性硬化症的青少年的步态变异性与认知之间的关联，研究对象包括48名最近被诊断为患有多发性硬化症的青少年（26名女孩；22名男孩），平均年龄16.0岁（标准差 = 2.2），扩展残疾状态量表（EDSS）评分为1.6（标准差 = 1.3）。使用电子步道研究步行速度和以平均步幅时间变异系数表示的步态变异性。通过一套计算机化的认知测试来评估认知。认知结果测量包括言语和非言语记忆、执行功能、视觉空间处理、言语功能、注意力、信息处理速度和运动技能。平均步行速度为76.9厘米/秒（标准差 = 57.6）；平均步幅时间变异性为3.5（标准差 = 1.3），整体认知评分为93.9（标准差 = 12.5）。根据线性回归分析，发现步幅时间变异性、注意力的认知子领域和信息处理速度之间存在显著关联。将步行速度纳入模型后，这种关联仍然显著。对于患有多发性硬化症的轻度残疾青少年，步态变异性增加而非步行速度增加被认为是认知表现的临床标志。
