Jeng Brenda, Motl Robert W
Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, 933 19th Street S, Suite 301, Birmingham, AL 35223 United States; Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, 1919 W Taylor St, 650 AHSB (MC 517), Chicago, IL 60612, United States.
Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, 933 19th Street S, Suite 301, Birmingham, AL 35223 United States; Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, 1919 W Taylor St, 650 AHSB (MC 517), Chicago, IL 60612, United States.
Mult Scler Relat Disord. 2022 Dec;68:104242. doi: 10.1016/j.msard.2022.104242. Epub 2022 Oct 17.
One major concern of excess body weight is diminished physical function. The excess body weight associated with obesity can bring about challenges for physical function, particularly walking performance, among persons living with the consequences of a chronic, neurological disease. There is evidence that persons with multiple sclerosis (MS) have significantly reduced walking performance compared with controls; however, the relationship between body composition and walking outcomes has not been well-defined in persons with MS. To that end, the study examined the associations between body composition metrics and a comprehensive battery of walking outcomes in persons with MS recruited across a wide distribution of body mass index.
Ambulatory participants with MS (n=64) underwent an assessment of neurological disability status using the Expanded Disability Status Scale (EDSS) and body composition metrics (i.e., percent body fat, fat mass, lean mass, bone mineral content and density) using dual-energy x-ray absorptiometry. Participants then completed the Timed 25-Foot Walk (T25FW), Timed Up and Go (TUG), 6-Minute Walk (6MW), and 12-Item Multiple Sclerosis Walking Scale (MSWS-12). We examined Spearman rank-order bivariate correlations among percent body fat, fat mass, lean mass, bone mineral content and density, T25FW, TUG, 6MW, MSWS-12, and EDSS.
Body composition metrics were not significantly associated with T25FW (r=-.11, .12), TUG (r=-.04, .11), 6MW (r=-.01, .20), and MSWS-12 (r=-.16, .03). Of note, body composition metrics were not correlated with disability status based on EDSS (r=-.11, .03). Body composition metrics were not associated with walking outcomes even after controlling for EDSS.
Our data indicated that worse body composition profiles are not necessarily associated with worse walking performance, greater perception of MS-related walking impairment, or more severe disability status in MS. Future research may consider examining other health-related or disease outcomes of overweight or obesity in MS. Overall, our findings suggest that optimization of body composition may not be a target of interventions for improving walking outcomes, and future research might explore other factors that influence lower physical function in MS.
体重超标引起的一个主要担忧是身体功能下降。与肥胖相关的体重超标会给身体功能带来挑战，尤其是对于患有慢性神经疾病的人来说，行走能力会受到影响。有证据表明，与对照组相比，多发性硬化症（MS）患者的行走能力明显下降；然而，在MS患者中，身体成分与行走结果之间的关系尚未明确界定。为此，本研究调查了广泛分布的体重指数范围内招募的MS患者的身体成分指标与一系列全面的行走结果之间的关联。
64名能够行走的MS患者使用扩展残疾状态量表（EDSS）评估神经残疾状况，并使用双能X线吸收法测量身体成分指标（即体脂百分比、脂肪量、瘦体重、骨矿物质含量和密度）。参与者随后完成25英尺定时步行（T25FW）、起立行走计时测试（TUG）、6分钟步行测试（6MW）和12项多发性硬化症步行量表（MSWS-12）。我们研究了体脂百分比、脂肪量、瘦体重、骨矿物质含量和密度、T25FW、TUG、6MW、MSWS-12和EDSS之间的Spearman等级双变量相关性。
身体成分指标与T25FW（r = -0.11，0.12）、TUG（r = -0.04，0.11）、6MW（r = -0.01，0.20）和MSWS-12（r = -0.16，0.03）均无显著相关性。值得注意的是，根据EDSS，身体成分指标与残疾状况无关（r = -0.11，0.03）。即使在控制EDSS之后，身体成分指标与行走结果也没有关联。
我们的数据表明，身体成分较差不一定与MS患者较差的行走能力、对MS相关行走障碍的更强感知或更严重的残疾状况相关。未来的研究可以考虑研究MS中超重或肥胖的其他与健康相关的或疾病结局。总体而言，我们的研究结果表明，优化身体成分可能不是改善行走结果的干预目标，未来的研究可能会探索影响MS患者身体功能下降的其他因素。
