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使用工程手套评估多发性硬化症患者的上肢功能。

Assessing upper limb function in multiple sclerosis using an engineered glove.

机构信息

Department of Health Sciences, University of Genoa, Genoa, Italy.

Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.

出版信息

Eur J Neurol. 2020 Dec;27(12):2561-2567. doi: 10.1111/ene.14482. Epub 2020 Sep 9.

Abstract

BACKGROUND AND PURPOSE

The importance of upper limb function in multiple sclerosis (MS) is increasingly recognized, especially for the evaluation of patients with progressive MS with reduced mobility. Two sensor-engineered gloves, able to measure quantitatively the timing of finger opposition movements, were previously used to assess upper limb disability in MS. The aims of the present study were: (1) to confirm the association between glove-derived variables and standard measures of MS disability in a larger cohort; (2) to assess the correlation with quantitative magnetic resonance imaging (MRI) and quality of life (QoL) measures; and (3) to determine if the glove-derived variables offer advantages over the standard measure for assessing upper limb function in MS, namely, the Nine-Hole Peg Test (9HPT).

METHODS

Sixty-five patients with MS, stable on disease-modifying treatment, were evaluated at baseline using the glove, and through clinical examination (Expanded Disability Status Scale, Symbol Digit Modalities Test, Timed 25-Foot Walk Test and 9HPT), MRI evaluation and QoL questionnaires. Correlations between the glove-derived variables and clinical, MRI and QoL variables were assessed using Spearman's rank correlation coefficient analysis.

RESULTS

Glove-derived variables significantly differed between patients with relapsing-remitting and those with progressive MS, with similar or slightly higher correlations of the 9HPT with clinical variables. We found greater correlations of the QoL physical component with glove-derived variables than with the 9HPT, and a significant correlation of its mental component with the glove-derived variables but not with the 9HPT.

CONCLUSION

The study results, confirming previous findings and showing advantages over the 9HPT, encourage the investigation of sensitivity to change in glove-derived variables in a longitudinal setting.

摘要

背景与目的

上肢功能在多发性硬化症(MS)中的重要性日益受到重视,尤其是对于运动能力降低的进展型 MS 患者的评估。之前曾使用两种带有传感器的手套来评估 MS 患者的上肢残疾程度,这两种手套能够定量测量手指对指运动的时间。本研究的目的为:(1)在更大的队列中证实手套衍生变量与 MS 残疾标准测量之间的关联;(2)评估与定量磁共振成像(MRI)和生活质量(QoL)测量的相关性;(3)确定手套衍生变量在评估 MS 患者的上肢功能方面是否优于标准测量,即 9 孔钉测试(9HPT)。

方法

65 例接受疾病修正治疗稳定的 MS 患者在基线时使用手套进行评估,并通过临床检查(扩展残疾状态量表、符号数字模态测试、定时 25 英尺步行测试和 9HPT)、MRI 评估和 QoL 问卷进行评估。使用 Spearman 等级相关系数分析评估手套衍生变量与临床、MRI 和 QoL 变量之间的相关性。

结果

手套衍生变量在复发缓解型和进展型 MS 患者之间存在显著差异,9HPT 与临床变量的相关性相似或略高。我们发现 QoL 生理成分与手套衍生变量的相关性大于与 9HPT 的相关性,而其心理成分与手套衍生变量具有显著相关性,但与 9HPT 无相关性。

结论

研究结果证实了先前的发现,并显示出优于 9HPT 的优势,鼓励在纵向研究中进一步研究手套衍生变量的敏感性变化。

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