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多发性硬化症患者的躯体感觉障碍:与动态姿势控制和上肢运动功能的关系。

Somatosensory impairments in patients with multiple sclerosis: association with dynamic postural control and upper extremity motor function.

机构信息

Physiotherapy and Rehabilitation, Department, Health Science Faculty, Hatay Mustafa Kemal University, Hatay, Turkey.

Neurologia Department, Tayfur Ata Sokmen Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey.

出版信息

Somatosens Mot Res. 2020 Jun;37(2):117-124. doi: 10.1080/08990220.2020.1753685. Epub 2020 Apr 15.

Abstract

We planned this study to bring attention to the somatosensory impairments in patients with multiple sclerosis (PwMS) and to investigate relationship of somatosensory impairments with dynamic postural stability and upper extremity motor function. Seven males and 23 females, 30 patients with mean EDSS 2.9 (SD = 1.4), aged between 18 and 65 years (mean = 41.43 ± 14.90 years) were included in this clinical study. Light touch sensorial assessment was made with Semmes Weinstein monofilament test and proprioception by distal proprioception test. Hand strength was measured by the Jamar dynamometer, fine motor skill was examined with nine-hole peg test, functional reach test in sitting and standing position was applied. Nottingham Extended Activities of Daily Living Scale (NEADLS) was used to measure everyday activities. We found a negative and moderate correlation between FRT in standing and light touch of the middle of the heel (right: -0.515), metatarsal bone (right : 0.453, left : -0.426), and medial of the foot (right : -0.462). There was a negative and moderate correlation between NEADLS and light touch of the metatarsal bone (right : -0.564, left : -0.472), medial of the foot (right : -0.531, left : -0.479), and lateral of the foot (right : -0.526). We found a positive and moderate correlation between proprioception of the ankle (right : 0.421 left : 0.588) and NEADLS. We found impairment in light touch and proprioception and, associations between sensorial functions and dynamic postural stability in PwMS. Also impaired sensorial functions cause dependent patients in daily living activities. In the assessment of balance and falling risk, independency in daily living activities; foot light touch and proprioception sense should be taken into account, hence it may provide guidance in planning rehabilitation programmes.Abbreviations: MS: multiple sclerosis; PwMS: patients with multiple sclerosis; VAS: visual analogue scale; FRT: functional reach test; 9-HPT: Nine-hole peg test; EDSS: The Expanded Disability Status Scale; NEADLS: Nottingham Extended Activities of Daily Living Scale.

摘要

我们计划进行这项研究,以引起人们对多发性硬化症患者(PwMS)感觉障碍的关注,并研究感觉障碍与动态姿势稳定性和上肢运动功能之间的关系。这项临床研究共纳入了 30 名患者,其中男性 7 名,女性 23 名,平均年龄为 41.43 ± 14.90 岁(18-65 岁),平均 EDSS 为 2.9(SD = 1.4)。触觉感觉评估采用 Semmes-Weinstein 单丝试验,本体感觉采用远端本体感觉试验。手的力量用 Jamar 握力计测量,精细运动技能用 9 孔钉测试检查,坐位和站位的功能性伸展测试(FRT)应用。诺丁汉扩展日常生活活动量表(NEADLS)用于测量日常活动。我们发现站立 FRT 与足跟中部(右侧:-0.515)、中足骨(右侧:0.453,左侧:-0.426)和足内侧(右侧:-0.462)的轻触呈负相关且中度相关。NEADLS 与中足骨(右侧:-0.564,左侧:-0.472)、足内侧(右侧:-0.531,左侧:-0.479)和足外侧(右侧:-0.526)的轻触呈负相关且中度相关。我们发现踝关节本体感觉(右侧:0.421,左侧:0.588)与 NEADLS 呈正相关且中度相关。我们发现多发性硬化症患者的轻触和本体感觉受损,以及感觉功能与动态姿势稳定性之间存在关联。此外,感觉功能受损会导致患者在日常生活活动中依赖他人。在评估平衡和跌倒风险时,应考虑到日常生活活动的独立性、足部轻触和本体感觉,这可能为规划康复计划提供指导。缩写:MS:多发性硬化症;PwMS:多发性硬化症患者;VAS:视觉模拟评分;FRT:功能性伸展测试;9-HPT:9 孔钉测试;EDSS:扩展残疾状况量表;NEADLS:诺丁汉扩展日常生活活动量表。

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