VIA University College, Faculty of Health Science, Department of Rehabilitation and Health Promotion Research, Hedeager 2, 8200 Aarhus N, Denmark; Aarhus University, Department of Public Health, Section of Sport Science, Dalgas Avenue 4, 8000 Aarhus, Denmark.
Aarhus University, Department of Public Health, Section of Sport Science, Dalgas Avenue 4, 8000 Aarhus, Denmark.
Mult Scler Relat Disord. 2019 Apr;29:137-144. doi: 10.1016/j.msard.2019.01.034. Epub 2019 Jan 24.
Despite the multitude of rehabilitation interventions targeting gait impairments in persons with multiple sclerosis (PwMS), only little is known about the relative association of muscle strength and balance on different gait outcomes.
To determine the relative association of balance and muscle strength to three gait performance outcomes in PwMS.
90 PwMS were enrolled in this cross-sectional study (72% women; mean age=49.8 ± 10.5 years; mean EDSS=3.7 ± 1.3. Spearman correlation and multivariate linear regression analysis were used to determine associations between three (dependent) gait outcomes (six-minute walk test (6MW), Timed 25-Foot Walk (T25FW), and Six Spot Step Test (SSST)). Explanatory variables were maximal muscle strength of the knee extensors, kneeflexors, plantarflexors and dorsiflexors, static balance (postural sway), functional balance (Mini-BESTest) and age and gender.
Static balance (r = 0.30 to 0.53; p<.05) and muscle strength of the knee extensors, knee flexors, plantarflexors and dorsiflexors (r = 0.28 to 0.47; p<.05) were weakly related to all gait performance outcomes, while functional balance showed strong relationships (r = 0.70 to 0.83; p<.05). Multivariate regression models including postural sway, muscle strength, and age and gender accounted for 32-39% of the variability in the 6MW, T25FW, and SSST. In 6MW and T25FW, with standardized beta coefficients for postural sway and muscle strength ranging from -0.34 to -0.37 (SE=0.09) and 0.18 to 0.35 (SE=0.10 to 0.12), respectively. For SSST, significant associations were only observed for balance.
Balance and muscle strength are significantly associated with gait performance during fast walking, whereas only balance was associated with more complex walking tasks.
尽管有许多针对多发性硬化症（MS）患者步态障碍的康复干预措施，但对于肌肉力量和平衡对不同步态结果的相对影响知之甚少。
确定平衡和肌肉力量与多发性硬化症患者三种步态表现结果的相对关系。
本横断面研究纳入了 90 名多发性硬化症患者（72%为女性；平均年龄=49.8±10.5 岁；平均 EDSS=3.7±1.3。使用 Spearman 相关分析和多元线性回归分析来确定三个（因变量）步态结果（6 分钟步行测试（6MW）、定时 25 英尺步行测试（T25FW）和六步台阶测试（SSST））之间的关联。解释变量为膝关节伸肌、膝屈肌、跖屈肌和背屈肌的最大肌肉力量、静态平衡（姿势摆动）、功能性平衡（Mini-BESTest）以及年龄和性别。
静态平衡（r=0.30 至 0.53；p<.05）和膝关节伸肌、膝屈肌、跖屈肌和背屈肌的肌肉力量（r=0.28 至 0.47；p<.05）与所有步态表现结果呈弱相关，而功能性平衡则呈强相关（r=0.70 至 0.83；p<.05）。包含姿势摆动、肌肉力量、年龄和性别在内的多元回归模型可以解释 6MW、T25FW 和 SSST 中 32%-39%的变异性。在 6MW 和 T25FW 中，姿势摆动和肌肉力量的标准化β系数分别为-0.34 至-0.37（SE=0.09）和 0.18 至 0.35（SE=0.10 至 0.12）。对于 SSST，仅观察到平衡与步态表现之间存在显著关联。
平衡和肌肉力量与快速行走时的步态表现显著相关，而只有平衡与更复杂的行走任务相关。
