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利用激光测距传感器的“起立-行走”计时测试分析颈椎病患者痉挛步态。

Analysis of Spastic Gait in Patients With Cervical Myelopathy Using the Timed Up and Go Test With a Laser Range Sensor.

机构信息

From the Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Spine (Phila Pa 1976). 2022 Jun 15;47(12):892-898. doi: 10.1097/BRS.0000000000004284. Epub 2021 Nov 19.

Abstract

STUDY DESIGN

Cross-sectional study.

OBJECTIVE

This study aimed to objectively evaluate spastic gait and reveal its novel characteristics via analysis of gait in patients with cervical myelopathy (CM) using the Timed Up and Go (TUG) test with a laser range sensor.

SUMMARY OF BACKGROUND DATA

Among patients with CM, spastic gait is a common diagnostic symptom; thus, objective assessments of spastic gait would be useful for the diagnosis of CM and recognition of disease status. Although spastic gait has been objectively evaluated in previous studies, the methods employed in those studies are not suitable for clinical settings.

METHODS

In total, 37 and 24 participants were recruited for a control group and CM group, respectively. CM was diagnosed by spine surgeons. We developed a laser TUG test, in which the position and velocity of both the legs were captured. The parameter values for both groups were statistically compared, and odds ratios were calculated using logistic regression analyses.

RESULTS

The total TUG-test time, time to stand up, time to first step, number of steps, and trajectory error for the CM group were significantly higher than those for the control group, whereas the average velocity and average stride length for the CM group were significantly lower than those for the control group. There was a significant independent association between the total TUG-test time and CM. The optimal cutoff point of the total test time for CM risk was approximately 9 seconds.

CONCLUSION

Through the use of the laser TUG test, we were able to identify characteristics of spastic gait, which leads to difficulty in standing and taking the first step, wobbling while walking, and an increased risk of falling. We found that the risk of CM was higher if the individual took longer than 9 seconds to complete the TUG test.Level of Evidence: 4.

摘要

研究设计

横断面研究。

目的

本研究旨在通过使用激光距离传感器的 TUG 测试对颈椎病(CM)患者的步态进行客观评估,分析痉挛步态,并揭示其新的特征。

背景资料概要

在 CM 患者中,痉挛步态是一种常见的诊断症状;因此,对痉挛步态进行客观评估将有助于 CM 的诊断和疾病状态的识别。尽管在以前的研究中已经对痉挛步态进行了客观评估,但这些研究中使用的方法不适合临床环境。

方法

共招募了 37 名和 24 名参与者作为对照组和 CM 组。CM 由脊柱外科医生诊断。我们开发了一种激光 TUG 测试,其中捕获了双腿的位置和速度。对两组的参数值进行了统计学比较,并使用逻辑回归分析计算了比值比。

结果

CM 组的总 TUG 测试时间、起立时间、第一步时间、步数和轨迹误差均显著高于对照组,而 CM 组的平均速度和平均步长显著低于对照组。总 TUG 测试时间与 CM 之间存在显著的独立关联。CM 风险的总测试时间最佳截断点约为 9 秒。

结论

通过使用激光 TUG 测试,我们能够识别痉挛步态的特征,这些特征导致站立和迈出第一步困难、行走时摇晃以及跌倒风险增加。我们发现,如果个体完成 TUG 测试的时间超过 9 秒,则 CM 的风险更高。

证据水平

4 级。

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