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强直性脊柱炎的临床状况与步态参数的关系。

Relationships between Clinical Status and Gait Parameters in Ankylosing Spondylitis.

机构信息

Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

出版信息

Clin Orthop Surg. 2023 Apr;15(2):249-256. doi: 10.4055/cios22112. Epub 2023 Jan 30.

Abstract

BACKGROUND

This study aimed to identify the relationship between gait parameters and health-related quality of life (HRQOL) in patients with ankylosing spondylitis (AS).

METHODS

The study group comprised 134 patients with AS and 124 patients were enrolled as controls. All study participants underwent instrumented gait analysis and completed clinical questionnaires. The kinematic parameters of gait were walking speed, step length, cadence, stance phase, single support, double support, phase coordination index (PCI), and gait asymmetry (GA). For each patient, a visual analog scale (VAS; 0-10) score was used to assess back pain, 36-item short form survey (SF-36) questionnaire was administered to evaluate the HRQOL, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was calculated. Using kinematic parameters and questionnaires, statistical analyses were done to investigate significant differences between the groups. Relationship of gait kinematic data and questionnaires of clinical outcome was also evaluated.

RESULTS

Among the 134 patients with AS, 34 were women and 100 were men. In the control group, 26 were women and 98 were men. The patients with AS and control group patients had significant differences in terms of walking speed, step length, single support, PCI, and GA. However, such differences were not observed in cadence, stance phase, and double support ( > 0.05). In correlation analyses, gait kinematic parameters and clinical outcomes were significantly related with each other. In multiple regression analysis performed to identify predictive factors for clinical outcome, walking speed was found to predict VAS, and walking speed and step length were found to predict the BASDAI and SF-36 scores.

CONCLUSIONS

Patients with and without AS had significant differences in the gait parameters. Correlation analysis showed significant correlation between the gait kinematic data and clinical outcomes. In particular, walking speed and step length successfully predicted clinical outcomes in patients with AS.

摘要

背景

本研究旨在确定强直性脊柱炎(AS)患者步态参数与健康相关生活质量(HRQOL)之间的关系。

方法

研究组包括 134 例 AS 患者,对照组包括 124 例患者。所有研究参与者均进行了仪器步态分析和临床问卷评估。步态的运动学参数包括步行速度、步长、步频、站立阶段、单支撑、双支撑、相位协调指数(PCI)和步态不对称(GA)。每位患者采用视觉模拟量表(VAS;0-10)评估腰痛,采用 36 项简短形式健康调查(SF-36)问卷评估 HRQOL,并计算 Bath 强直性脊柱炎疾病活动指数(BASDAI)。使用运动学参数和问卷进行统计分析,以比较组间差异。还评估了步态运动学数据与临床结果问卷之间的关系。

结果

在 134 例 AS 患者中,女性 34 例,男性 100 例;对照组中,女性 26 例,男性 98 例。AS 患者和对照组患者在步行速度、步长、单支撑、PCI 和 GA 方面存在显著差异。然而,在步频、站立阶段和双支撑方面没有观察到差异(>0.05)。在相关分析中,步态运动学参数与临床结果显著相关。在进行识别临床结果预测因素的多元回归分析时,发现步行速度可预测 VAS,步行速度和步长可预测 BASDAI 和 SF-36 评分。

结论

AS 患者和无 AS 患者的步态参数存在显著差异。相关分析显示步态运动学数据与临床结果之间存在显著相关性。特别是,步行速度和步长可成功预测 AS 患者的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d374/10060776/a77260d72ac6/cios-15-249-g001.jpg

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