Marcu Florin Mihai, Brihan Ilarie, Ciubara Anamaria, Lupu Vasile Valeriu, Negrut Nicoleta, Jurcau Anamaria, Lupu Ancuta, Burlea Stefan Lucian, Dragan Felicia, Butnariu Lacramioara Ionela, Ignat Alina Elena, Ciubara Alexandru Bogdan
Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania.
Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800008 Galati, Romania.
Life (Basel). 2023 Jul 3;13(7):1501. doi: 10.3390/life13071501.
(1) Background: Multiple sclerosis (MS), a chronic progressive neurological disorder which affects the central nervous system (CNS), can result in disorders of all the functions controlled by the CNS: motor, sensory, cognitive and emotional. Physical therapy (PT), conducted through proprioceptive neuromuscular facilitation (PNF) techniques, can be customized to the individual patient's needs and has the potential to improve the patient's evolution. This study aims to establish if PT based on PNF techniques has a beneficial role in MS treatment. (2) Methods: We performed a prospective study on 40 patients who were diagnosed with MS and previously treated only with MS drug treatment (DT). These patients have participated in a PT program throughout one year. At the beginning and at the end of our study, after one year, we have assessed the following parameters: timed walk for 25 feet (Timed 25-Foot Walk test- T25FW test), dexterity of the upper limbs (9-Hole Peg Test-9HPT), disability level (Expanded Disability Status Scale-EDSS) and cognitive function (Paced Auditory Serial Addition Test-PASAT. (3) Results: In subjects in the early stages of MS, lower limb mobility improved significantly, T25FW decreasing from 6.46 to 5.80 ( < 0.001) and upper limb ability increased significantly in the dominant hand, 9HPT decreasing from 17.73 to 16.97 ( = 0.006) and not significantly in the non-dominant hand, 9HPT decreasing from 17.73 to 17.50 ( = 0.255). Furthermore, among these subjects, cognitive performance improved; their PASAT increased from 52.14 to 54.14 ( = 0.036), while the level of disability of these subjects improved only slightly, the EDSS scale evolving from 3.08 to 2.91 ( = 0.650). (4) Conclusions: In patients with early forms of MS, combining DT with a PT program based on PNF techniques results in: regaining muscle strength in the lower limbs, improving coordination while walking, correcting dexterity in the upper limbs and increasing the ability to concentrate.
（1）背景：多发性硬化症（MS）是一种影响中枢神经系统（CNS）的慢性进行性神经疾病，可导致中枢神经系统控制的所有功能出现障碍，包括运动、感觉、认知和情感功能。通过本体感觉神经肌肉促进法（PNF）技术进行的物理治疗（PT）可根据个体患者的需求进行定制，并且有可能改善患者的病情发展。本研究旨在确定基于PNF技术的物理治疗在MS治疗中是否具有有益作用。（2）方法：我们对40例被诊断为MS且之前仅接受过MS药物治疗（DT）的患者进行了一项前瞻性研究。这些患者参加了为期一年的物理治疗项目。在研究开始时和结束时，即一年后，我们评估了以下参数：25英尺定时步行（25英尺定时步行测试 - T25FW测试）、上肢灵活性（9孔插钉测试 - 9HPT）、残疾程度（扩展残疾状态量表 - EDSS）和认知功能（听觉节律连续加法测试 - PASAT）。（3）结果：在MS早期阶段的受试者中，下肢活动能力显著改善，T25FW从6.46降至5.80（<0.001），优势手的上肢能力显著提高，9HPT从17.73降至16.97（=0.006），非优势手则无显著变化，9HPT从17.73降至17.50（=0.255）。此外，在这些受试者中，认知表现有所改善；他们的PASAT从52.14提高到54.14（=0.036），而这些受试者的残疾程度仅略有改善，EDSS量表从3.08变为2.91（=0.650）。（4）结论：在早期MS患者中，将药物治疗与基于PNF技术的物理治疗项目相结合可带来：恢复下肢肌肉力量、改善行走时的协调性、纠正上肢灵活性以及提高注意力集中能力。
