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肌萎缩侧索硬化症患者跌倒与平衡、力量和痉挛客观测量指标的相关性。

Correlation of falls in patients with Amyotrophic Lateral Sclerosis with objective measures of balance, strength, and spasticity.

作者信息

Schell Wendy E, Mar Victoria S, Da Silva Carolyn P

机构信息

Houston Methodist Hospital Neurological Institute Amyotrophic Lateral Sclerosis clinic, Houston, TX, USA.

School of Physical Therapy, Texas Woman's University, Houston, TX, USA.

出版信息

NeuroRehabilitation. 2019;44(1):85-93. doi: 10.3233/NRE-182531.

Abstract

BACKGROUND

Persons diagnosed with Amyotrophic Lateral Sclerosis (ALS) often demonstrate neurological deficits that predispose them to repeated falls and associated adverse consequences. Determining contributing factors to falls in this population is critical to improve safety and patient outcomes.

OBJECTIVE

The purpose of this study was to correlate clinical measures of gait speed, balance, strength, spasticity, and a self-reported rating scale of function with fall incidence in individuals with ALS.

METHODS

Thirty-one participants with a confirmed ALS diagnosis were recruited from an outpatient clinic. Each participant performed the following tests: timed gait speed, Berg Balance Scale (BBS), manual muscle testing (MMT) for lower extremity (LE) strength, Modified Ashworth Scale (MAS) for LE spasticity, and the ALS Functional Rating Scale-Revised (ALSFRS-R). Each participant reported number of falls that occurred in the past three months. Pearson correlation coefficients were calculated to determine correlations between variables.

RESULTS

Significant correlation was found between fall incidence and composite LE strength score (rp = 0.385, p = 0.032).

CONCLUSIONS

There is a relationship between LE weakness and number of falls in the ALS population. Preventing disuse-related LE muscle weakness and education of need for external support may decrease the number of falls experienced by individuals with ALS.

摘要

背景

被诊断患有肌萎缩侧索硬化症(ALS)的患者常表现出神经功能缺损,这使他们容易反复跌倒并引发相关不良后果。确定该人群跌倒的促成因素对于提高安全性和患者预后至关重要。

目的

本研究的目的是将步态速度、平衡、力量、痉挛的临床测量指标以及自我报告的功能评定量表与ALS患者的跌倒发生率相关联。

方法

从一家门诊诊所招募了31名确诊为ALS的参与者。每位参与者进行了以下测试:定时步态速度、伯格平衡量表(BBS)、下肢(LE)力量的徒手肌力测试(MMT)、下肢痉挛的改良Ashworth量表(MAS)以及修订的ALS功能评定量表(ALSFRS-R)。每位参与者报告过去三个月内发生的跌倒次数。计算Pearson相关系数以确定变量之间的相关性。

结果

发现跌倒发生率与下肢综合力量评分之间存在显著相关性(rp = 0.385,p = 0.032)。

结论

ALS人群中下肢无力与跌倒次数之间存在关联。预防与废用相关的下肢肌肉无力以及对外部支持需求的教育可能会减少ALS患者的跌倒次数。

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