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使用统计参数映射对轻度残疾多发性硬化症患者进行运动步态分析:一项横断面研究。

Kinematic Gait Analysis in People with Mild-Disability Multiple Sclerosis Using Statistical Parametric Mapping: A Cross-Sectional Study.

机构信息

Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain.

Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain.

出版信息

Sensors (Basel). 2023 Sep 5;23(18):7671. doi: 10.3390/s23187671.

Abstract

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. Gait abnormalities, such as altered joint kinematics, are common in people with MS (pwMS). Traditional clinical gait assessments may not detect subtle kinematic alterations, but advances in motion capture technology and analysis methods, such as statistical parametric mapping (SPM), offer more detailed assessments. The aim of this study was to compare the lower-limb joint kinematics during gait between pwMS and healthy controls using SPM analysis. Methods: A cross-sectional study was conducted involving pwMS and healthy controls. A three-dimensional motion capture system was used to obtain the kinematic parameters of the more affected lower limb (MALL) and less affected lower limb (LALL), which were compared using the SPM analysis. Results: The study included 10 pwMS with mild disability (EDSS ≤ 3) and 10 healthy controls. The results showed no differences in spatiotemporal parameters. However, significant differences were observed in the kinematics of the lower-limb joints using SPM. In pwMS, compared to healthy controls, there was a higher anterior pelvis tilt (MALL, = 0.047), reduced pelvis elevation (MALL, = 0.024; LALL, = 0.044), reduced pelvis descent (MALL, = 0.033; LALL, = 0.022), reduced hip extension during pre-swing (MALL, = 0.049), increased hip flexion during terminal swing (MALL, = 0.046), reduced knee flexion (MALL, = 0.04; LALL, < 0.001), and reduced range of motion in ankle plantarflexion (MALL, = 0.048). : pwMS with mild disability exhibit specific kinematic abnormalities during gait. SPM analysis can detect alterations in the kinematic parameters of gait in pwMS with mild disability.

摘要

多发性硬化症(MS)是一种影响中枢神经系统的慢性自身免疫性疾病。步态异常,如关节运动学改变,在多发性硬化症患者(pwMS)中很常见。传统的临床步态评估可能无法检测到细微的运动学改变,但运动捕捉技术和分析方法的进步,如统计参数映射(SPM),提供了更详细的评估。本研究旨在使用 SPM 分析比较 pwMS 和健康对照者在步态中下肢关节的运动学。

方法

进行了一项横断面研究,包括 pwMS 和健康对照者。使用三维运动捕捉系统获得更受影响的下肢(MALL)和较少受影响的下肢(LALL)的运动学参数,并使用 SPM 分析进行比较。

结果

该研究纳入了 10 名轻度残疾(EDSS ≤ 3)的 pwMS 和 10 名健康对照者。结果显示,时空参数无差异。然而,SPM 显示下肢关节运动学存在显著差异。与健康对照组相比,pwMS 中骨盆前倾角度较大(MALL, = 0.047),骨盆抬高减少(MALL, = 0.024;LALL, = 0.044),骨盆下降减少(MALL, = 0.033;LALL, = 0.022),预摆时髋关节伸展减少(MALL, = 0.049),终摆时髋关节屈曲增加(MALL, = 0.046),膝关节屈曲减少(MALL, = 0.04;LALL, < 0.001),踝关节跖屈运动范围减小(MALL, = 0.048)。

结论

轻度残疾的 pwMS 在步态中表现出特定的运动学异常。SPM 分析可以检测到轻度残疾的 pwMS 步态运动学参数的改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d97/10535645/4d01a0105319/sensors-23-07671-g001.jpg

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