Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hopital Tenon, 75020 Paris, France.
Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hopital Tenon, 75020 Paris, France.
Ann Phys Rehabil Med. 2020 Mar;63(2):106-110. doi: 10.1016/j.rehab.2019.11.007. Epub 2020 Jan 22.
Lower urinary tract symptoms, especially overactive bladder, are frequent and disabling in individuals with multiple sclerosis (IwMS). An association with gait disorders is common, which could aggravate continence difficulties and affect quality of life. The association between the need to void and walking has never been studied in this population.
The primary aim of this study was to assess the effect of a strong desire to void (SDV) on walking speed in IwMS and lower urinary tract symptoms. The secondary aim was to identify clinical or urodynamic factors associated with walking speed impairment at SDV in this population.
We included IwMS with urinary disorders and Expanded Disability Status Scale score<7 in this observational study. Individuals underwent 3 10-m walk tests (10MWT) and one Timed Up and Go (TUG) test at SDV and at post-void (PV).
Among the 72 IwMS included (mean [SD] age 50.6 [11.6] years; 46 [64%] females), the mean (SD) speed for 10MWT was 1.00 (0.31) m.s at SDV and 1.07 (0.30) m.s at PV (P<0.0001). Time for TUG was also increased when individuals felt SDV: mean 11.53 (4.6) sec at SDV versus 10.77 (3.8) sec at PV (P=0.004). No predictors of greater impairment of walking speed at SDV were identified.
This study suggests a clinical impact of bladder sensation on walking speed in IwMS and urinary disorders. None of the individual characteristics could predict greater decrease in gait velocity at SDV.
下尿路症状，尤其是膀胱过度活动症，在多发性硬化症（MS）患者中较为常见且具有致残性。此类患者常伴有步态障碍，这可能会加重控尿困难，并影响生活质量。但目前尚未有研究探讨此类患者排尿需求与行走之间的关系。
本研究旨在评估强烈排尿欲望（SDV）对 MS 伴尿路障碍患者的行走速度及下尿路症状的影响，并确定与该人群 SDV 时行走速度受损相关的临床或尿动力学因素。
我们纳入了伴有排尿障碍且扩展残疾状况量表评分<7 的 MS 患者，进行了 3 次 10 米步行测试（10MWT）和 1 次计时起立行走测试（TUG），分别在 SDV 时和排尿后（PV）进行。
72 例 MS 患者（平均[标准差]年龄 50.6[11.6]岁，46 例[64%]女性）中，SDV 时的 10MWT 平均速度为 1.00（0.31）m/s，PV 时为 1.07（0.30）m/s（P<0.0001）。TUG 时间也随着 SDV 而增加：SDV 时为 11.53（4.6）秒，PV 时为 10.77（3.8）秒（P=0.004）。SDV 时行走速度受损更严重的预测因素未被确定。
本研究提示膀胱感觉对 MS 伴尿路障碍患者行走速度存在临床影响。个体特征均无法预测 SDV 时步态速度的下降程度更大。
