Slavkovic Sanela, Golubovic Spela, Vojnovic Matilda, Nadj Congor
University of Novi Sad, Faculty of Medicine, Department for Special Rehabilitation and Education, Hajduk Veljkova 3, 21000 Novi Sad, Serbia.
University of Novi Sad, Faculty of Medicine, Department of General Medicine, Hajduk Veljkova 3, 21000 Novi Sad, Serbia.
Zdr Varst. 2019 Mar 26;58(2):54-61. doi: 10.2478/sjph-2019-0007. eCollection 2019 Mar.
Multiple sclerosis (MS) results in a wide range of disabilities. The effects of cognitive and motor dysfunctions are significant and affect level of functioning in people with MS.
The aim of the research was to determine the common contribution of neurological, motor and cognitive status to the overall functioning of MS patients.
The sample consisted of 108 subjects with RRMS. The instruments used in the research included: The General Questionnaire, the World Health Organization Disability Assessment Schedule, the Audio Recorded Cognitive Screen, Paced Auditory Serial Addition Test, the Nine Hole Peg Test, the 25 Foot Walk Test, and the Expanded Disability Status Scale.
Subjects with a mild neurological deficit had a higher level of current functioning in all domains (a lower WHODAS 2.0 score) than subjects with a moderate neurological deficit (r=0.43, p<0.001). We found a positive correlation between the level of cognitive impairment and motor deficits of both upper and lower extremities and the level of neurological deficit (p<0.001). Subjects with lower neurological deficits had significantly lower WHODAS 2.0. scores, i.e. better motor abilities of both upper and lower extremities than subjects with moderate neurological deficits (p<0.001). The greatest contribution to explaining the overall level of current functioning of people with MS had subjects' age, cognitive abilities and motor abilities of the upper extremities.
Inverse relationship of neurological, motor and cognitive status affects the overall daily functioning of people with MS, requiring planning of comprehensive programs in the rehabilitation of people with MS.
多发性硬化症（MS）会导致多种残疾。认知和运动功能障碍的影响显著，会影响MS患者的功能水平。
本研究旨在确定神经、运动和认知状态对MS患者整体功能的共同影响。
样本包括108名复发缓解型多发性硬化症（RRMS）患者。研究中使用的工具包括：一般问卷、世界卫生组织残疾评估量表、音频记录认知筛查、听觉连续加法测试、九孔插板测试、25英尺步行测试和扩展残疾状态量表。
与中度神经功能缺损的受试者相比，轻度神经功能缺损的受试者在所有领域的当前功能水平更高（世界卫生组织残疾评估量表2.0得分更低）（r = 0.43，p < 0.001）。我们发现认知障碍水平与上下肢运动功能缺损程度和神经功能缺损程度之间呈正相关（p < 0.001）。与中度神经功能缺损的受试者相比，神经功能缺损程度较低的受试者的世界卫生组织残疾评估量表2.0得分显著更低，即上下肢运动能力更好（p < 0.001）。对解释MS患者当前整体功能水平贡献最大的因素是受试者的年龄、认知能力和上肢运动能力。
神经、运动和认知状态的反向关系会影响MS患者的整体日常功能，这需要为MS患者制定全面的康复计划。
