Unit of Neurorehabilitation, University Hospital of Pisa, Pisa, Italy.
NeuroRehabilitation. 2020;46(3):321-331. doi: 10.3233/NRE-192997.
An intensive task-oriented circuit training (TOCT) provides a valid approach in improving motor function in Multiple Sclerosis (MS).
We aimed at testing the efficacy of TOCT on gait kinematics in MS patients with mild-moderate disability.
Nineteen MS patients able of independent walking performed 3-D Gait Analysis before (T0) and after (T1) a two-week TOCT program. Patients were clustered in two different subgroups, according to clinical neurological impairments assessed with specific functional system of Expanded Disability Status Scale (EDSS): pyramidal (Group 1) and cerebellar (Group 2) subjects. Spatio-temporal and kinematic data were compared before and after the TOCT intervention in the total sample of patients and in the two selected subgroups at two time intervals.
Data obtained revealed increased dynamic ROM at knee joint after training in the whole study sample. Of note, knee dynamic excursion improved significantly in Group 1 but not in Group 2 patients after TOCT. Moreover, sagittal plane kinematics revealed significant modifications on knee and ankle biomechanics in Group 1 after rehabilitation.
These data point out the benefits of the task specific training on gait dynamics in mild impaired MS subjects, linking to treatment opportunity in patients with a prevalent pyramidal impairment.
强化任务导向式的循环训练（TOCT）是改善多发性硬化症（MS）患者运动功能的有效方法。
我们旨在测试 TOCT 对轻度至中度残疾的 MS 患者步态运动学的疗效。
19 名能够独立行走的 MS 患者在两周的 TOCT 方案前（T0）和后（T1）进行了 3D 步态分析。根据扩展残疾状况量表（EDSS）特定功能系统评估的临床神经损伤，患者分为两个不同的亚组：锥体（第 1 组）和小脑（第 2 组）。在整个患者样本和两个选定的亚组中，在两个时间间隔比较了 TOCT 干预前后的时空和运动学数据。
训练后，患者整体的膝关节动态 ROM 增加。值得注意的是，TOCT 后，第 1 组患者的膝关节动态活动度明显改善，但第 2 组患者没有。此外，在康复后，第 1 组矢状面运动学显示膝关节和踝关节生物力学有明显变化。
这些数据表明，任务特异性训练对轻度受损 MS 患者的步态动力学有益，与主要锥体损伤患者的治疗机会有关。
