From the IRCCS - Fondazione Don Carlo Gnocchi, Milan, Italy (DC, EG, JJ); IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy (EP, EBi, EBe); IRCCS - Fondazione Don Carlo Gnocchi, Rome, Italy (IA, II, AC); Ospedale San Carlo Borromeo, Milan, Italy (RR); and Laboratorio di Cinematica e Robotica, IRCCS - Fondazione Ospedale San Camillo, Venice, Italy (MA).
Am J Phys Med Rehabil. 2020 Jan;99(1):41-47. doi: 10.1097/PHM.0000000000001272.
The aims of the study were to compare mobility in multiple sclerosis, Parkinson disease, and stroke, and to quantify the relationship between mobility and participation restrictions.
This is a multicenter cross-sectional study. Included were compliant subjects with Parkinson disease, multiple sclerosis, and stroke seen for rehabilitation, with no comorbidities interfering with mobility. Functional scales were applied to each subject to investigate gait speed (10-meter walking test), balance while maintaining body position (Berg Balance Scale), dynamic balance and mobility (Timed Up and Go and Dynamic Gait Index), and participation (Community Integration Questionnaire).
Two hundred ninety-nine patients (111 multiple sclerosis, 94 Parkinson disease, and 94 stroke) were enrolled. Stroke had the slowest gait speed (mean gait speed = 0.9 m/sec) compared with Parkinson disease (1.1 m/sec), and multiple sclerosis (1.2 m/sec) (P < 0.001). Multiple sclerosis was more limited than Parkinson disease and stroke in dynamic balance both in the Timed Up and Go Test (multiple sclerosis = 16.7 secs, Parkinson disease = 11.4 secs, stroke = 14.0 secs; P < 0.001) and Dynamic Gait Index (multiple sclerosis = 11.6 points, Parkinson disease = 12.9 points, stroke = 13.6 points; P = 0.03); ability to maintain balance and body position (Berg Balance Scale) was more affected in stroke and Parkinson disease than multiple sclerosis (multiple sclerosis = 42.6 points, Parkinson disease = 39.4 points, stroke = 39.7 points; P = 0.03). Balance disorders were associated with participation restrictions but not gait speed.
Neurological conditions have differing impacts on gait and balance, leading to different levels of participation restriction.
本研究旨在比较多发性硬化症、帕金森病和中风患者的活动能力，并量化活动能力与参与受限之间的关系。
这是一项多中心横断面研究。纳入了接受康复治疗的、无合并症干扰活动能力的帕金森病、多发性硬化症和中风患者。每位患者均接受了功能量表评估，包括步行速度（10 米步行测试）、维持身体姿势的平衡能力（伯格平衡量表）、动态平衡和活动能力（计时起立行走测试和动态步态指数）以及参与能力（社区融入问卷）。
共纳入 299 名患者（多发性硬化症 111 例、帕金森病 94 例和中风 94 例）。与帕金森病（1.1 m/s）和多发性硬化症（1.2 m/s）相比，中风患者的步行速度最慢（平均步行速度=0.9 m/s）（P<0.001）。多发性硬化症在计时起立行走测试和动态步态指数中动态平衡能力方面较帕金森病和中风受限更明显（多发性硬化症=16.7 秒，帕金森病=11.4 秒，中风=14.0 秒；P<0.001）和动态步态指数（多发性硬化症=11.6 分，帕金森病=12.9 分，中风=13.6 分；P=0.03）；平衡和身体姿势维持能力（伯格平衡量表）在中风和帕金森病患者中较多发性硬化症患者更受影响（多发性硬化症=42.6 分，帕金森病=39.4 分，中风=39.7 分；P=0.03）。平衡障碍与参与受限相关，但与步态速度无关。
不同的神经疾病对步态和平衡有不同的影响，导致不同程度的参与受限。
