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多发性硬化症患者呼吸功能、平衡、姿势控制和疲劳之间的关联:一项观察性研究。

Associations between respiratory function, balance, postural control, and fatigue in persons with multiple sclerosis: an observational study.

机构信息

Faculty of Physical Activity and Sport Sciences, European University of Madrid, Madrid, Spain.

出版信息

Front Public Health. 2024 Mar 20;12:1332417. doi: 10.3389/fpubh.2024.1332417. eCollection 2024.

Abstract

INTRODUCTION

Fatigue, postural control impairments, and reduced respiratory capacities are common symptoms in persons diagnosed with Multiple Sclerosis (MS). However, there is a paucity of evidence establishing correlations among these factors. The aim of this study is to analyze respiratory function in persons with MS compared to the control group as well as to analyze the relationship between fatigue, respiratory function and postural control in persons with MS.

MATERIALS AND METHODS

A total of 17 persons with MS and 17 healthy individuals were enrolled for this cross-sectional study. The evaluated parameters included fatigue assessed using the Visual Analog Scale-fatigue (VAS-F) and the Borg Dyspnea Scale, postural control assessed through the Mini Balance Evaluation System Test (Mini-BESTest), Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Trunk Impairment Scale (TIS); and respiratory capacities measured by Maximum Inspiratory Pressure (MIP), Maximum Expiratory Pressure (MEP), Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), FEV1/FVC ratio, Diaphragmatic excursion and diaphragmatic thickness.

RESULTS

A very high correlation was observed between the Borg Dyspnoea Scale and the BBS ( = -0.768), TUG (0.867), and Mini-BESTest ( = -0.775). The VAS-F exhibited an almost perfect correlation solely with the TUG (0.927). However, none of the variables related to fatigue exhibited any correlation with the respiratory variables under study. Balance-related variables such as BBS and Mini-BESTest demonstrated a very high and high correlation. Respectively, with respiratory function variables MEP ( = 0.783;  = 0.686), FVC ( = 0.709;  = 0.596), FEV1 ( = 0.615;  = 0.518). BBS exhibited a high correlation with diaphragmatic excursion ( = 0.591). Statistically significant differences were noted between the persons with MS group and the control group in all respiratory and ultrasound parameters except for diaphragmatic thickness.

CONCLUSION

The findings suggest that decreased postural control and balance are associated with both respiratory capacity impairments and the presence of fatigue in persons with MS. However, it is important to note that the alterations in respiratory capacities and fatigue are not mutually related, as indicated by the data obtained in this study. Discrepancies were identified in abdominal wall thickness, diaphragmatic excursion, and respiratory capacities between persons with MS and their healthy counterparts.

摘要

简介

疲劳、姿势控制障碍和呼吸能力下降是多发性硬化症(MS)患者的常见症状。然而,目前很少有证据表明这些因素之间存在相关性。本研究旨在分析 MS 患者的呼吸功能,并与对照组进行比较,同时分析 MS 患者的疲劳、呼吸功能和姿势控制之间的关系。

材料和方法

本研究为横断面研究,共纳入 17 名 MS 患者和 17 名健康个体。评估参数包括使用视觉模拟量表疲劳(VAS-F)和 Borg 呼吸困难量表评估的疲劳,使用 Mini-Balance Evaluation System Test(Mini-BESTest)、Berg 平衡量表(BBS)、计时起立行走测试(TUG)和躯干障碍量表(TIS)评估的姿势控制,以及使用最大吸气压力(MIP)、最大呼气压力(MEP)、用力肺活量(FVC)、第一秒用力呼气量(FEV1)、FEV1/FVC 比值、膈肌活动度和膈肌厚度测量的呼吸能力。

结果

Borg 呼吸困难量表与 BBS(r=-0.768)、TUG(r=0.867)和 Mini-BESTest(r=-0.775)之间存在很强的相关性。VAS-F 仅与 TUG(r=0.927)存在几乎完美的相关性。然而,与疲劳相关的变量与研究中的呼吸变量之间没有相关性。平衡相关变量,如 BBS 和 Mini-BESTest 与呼吸功能变量 MEP(r=0.783;r=0.686)、FVC(r=0.709;r=0.596)、FEV1(r=0.615;r=0.518)之间存在很强和高的相关性。BBS 与膈肌活动度(r=0.591)有很高的相关性。在所有呼吸和超声参数中,MS 组和对照组之间存在统计学显著差异,除了膈肌厚度。

结论

研究结果表明,姿势控制和平衡的下降与 MS 患者的呼吸能力下降和疲劳的存在有关。然而,需要注意的是,正如本研究所得数据所示,呼吸能力和疲劳的改变之间没有相互关系。MS 患者和健康对照组之间的腹壁厚度、膈肌活动度和呼吸能力存在差异。

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