Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany.
Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany.
Clin Neurol Neurosurg. 2021 Oct;209:106888. doi: 10.1016/j.clineuro.2021.106888. Epub 2021 Aug 17.
Gait impairment is the cardinal motor symptom in hereditary spastic paraplegias (HSPs) possibly linked to increased fear of falling and reduced quality of life (QoL). Disease specific symptoms in HSP are rated using the Spastic Paraplegia Rating Scale (SPRS). However, limited studies evaluated more objectively easy-to-apply gait measures by comparing these standardized assessments with patients' self-perceived impairment and clinically established scores. Therefore, the aim of this study was to correlate functional gait measures with self-rating questionnaires for fear of falling and QoL, and with the SPRS as clinical gold standard.
HSP patients ("pure" phenotype, n = 22) fulfilling the clinical diagnostic criteria for HSP and age-and gender-matched healthy subjects (n = 22) were included in this study. Motor impairment was evaluated using the SPRS, fear of falling by the Falls Efficacy Scale-International (FES-I), and QoL by SF-12. Functional gait measures included gait speed and step length (10-meter-walk-test), the Timed up and go test (TUG), and maximum walking distance (2-min-walking-test).
Functional gait measures correlated to fear of falling (gait speed: r = -0.726; step length: r = -0.689; TUG: r = 0.721; 2-min: r = -0.709) and the physical component of QoL (gait speed: r = 0.541; step length: r = 0.531; TUG: r = -0.512; 2-min: r = 0.548). Furthermore, FES-I (r = 0.767) and QoL (r = -0.728) correlated with the clinical gold standard (SPRS). Gait measures strongly correlated with SPRS (gait speed: r = -0.787; step length: r = -0.821; TUG: r = 0.756; 2-min: r = -0.791).
Functional gait measures reflect fear of falling, QoL, and mobility in HSP. The metric, semi-quantitative gait measures complement the clinician's evaluation and support the clinical workup by more objective parameters.
步态障碍是遗传性痉挛性截瘫（HSP）的主要运动症状，可能与跌倒恐惧增加和生活质量（QoL）下降有关。HSP 的疾病特异性症状使用痉挛性截瘫评分量表（SPRS）进行评估。然而，有限的研究通过将这些标准化评估与患者的自我感知障碍和临床既定评分进行比较，更客观地评估了易于应用的步态测量方法。因此，本研究旨在将功能性步态测量与跌倒恐惧和 QoL 的自我评估问卷以及作为临床金标准的 SPRS 相关联。
本研究纳入了符合 HSP 临床诊断标准的 HSP 患者（“纯”表型，n=22）和年龄、性别匹配的健康对照者（n=22）。使用 SPRS 评估运动障碍，使用跌倒效能量表-国际版（FES-I）评估跌倒恐惧，使用 SF-12 评估 QoL。功能性步态测量包括 10 米步行测试的步行速度和步长、计时起立行走测试（TUG）和最大步行距离（2 分钟步行测试）。
功能性步态测量与跌倒恐惧（步行速度：r=-0.726；步长：r=-0.689；TUG：r=0.721；2 分钟：r=-0.709）和 QoL 的生理成分（步行速度：r=0.541；步长：r=0.531；TUG：r=-0.512；2 分钟：r=0.548）相关。此外，FES-I（r=0.767）和 QoL（r=-0.728）与临床金标准（SPRS）相关。步态测量与 SPRS 呈强相关（步行速度：r=-0.787；步长：r=-0.821；TUG：r=0.756；2 分钟：r=-0.791）。
功能性步态测量反映 HSP 中的跌倒恐惧、QoL 和移动能力。这些定量、半定量的步态测量方法补充了临床医生的评估，并通过更客观的参数支持临床评估。
