University of Vermont, Rehabilitation and Movement Science, Burlington, VT, USA.
University of Vermont, Rehabilitation and Movement Science, Burlington, VT, USA.
Gait Posture. 2024 Jun;111:99-104. doi: 10.1016/j.gaitpost.2024.04.018. Epub 2024 Apr 20.
Impairments in real-world gait quality and quantity are multifaceted for individuals with multiple sclerosis (MS), encompassing mobility, cognition, and fear of falling. However, these factors are often examined independently, limiting insights into the combined contributions they make to real-world ambulation.
How do mobility, cognition, and fear of falling contribute to real-world gait quality and quantity in individuals with MS?
Twenty individuals with MS underwent a series of cognitive assessments, including the Paced Auditory Serial Addition Test (PASAT), Symbol Digits Modalities Test (SDMT), Stroop Test, and the Selective Reminding Test (SRT). Participants also completed the Falls Efficacy Scale - International (FES-I) and walking impairment using the Patient Determined Disease Steps (PDDS). Following the in-lab session, participants wore an inertial sensor on their lower back and asked to go about their typical daily routines for three days. Metrics of gait speed, stride regularity, time spent walking, and total bouts were extracted from the real-world data.
Significant correlations were found between both real-world gait speed and stride regularity and the SDMT, FES-I, and PDDS. Backward linear regression analysis was conducted for gait speed and stride regularity, with PDDS and SDMT included in the final model for both metrics. These variables explained 63% of the variance in gait speed and 69% of the variance in stride regularity. Results were not significant for gait quantity after adjusting for age and sex.
The study's results provide insight regarding the roles of cognition, walking impairment, and fear of falling on real-world ambulation. Deeper understanding of these contributions can inform the development of targeted interventions that aim to improve walking. Additionally, the absence of significant correlations between gait metrics, cognition, and fear of falling with gait quantity underscores the need for further research to identify factors that increased walking in this population.
多发性硬化症（MS）患者的现实世界步态质量和数量受损是多方面的，包括移动能力、认知能力和跌倒恐惧。然而，这些因素通常是独立检查的，限制了对它们对现实世界步行的综合贡献的深入了解。
移动能力、认知能力和跌倒恐惧如何共同影响 MS 患者的现实世界步态质量和数量？
20 名 MS 患者接受了一系列认知评估，包括 Paced Auditory Serial Addition Test（PASAT）、Symbol Digits Modalities Test（SDMT）、Stroop 测试和 Selective Reminding Test（SRT）。参与者还完成了 Falls Efficacy Scale-International（FES-I）和使用患者确定疾病步骤（PDDS）的步行障碍评估。在实验室会议结束后，参与者在腰部佩戴惯性传感器，并要求他们在三天内进行典型的日常活动。从现实世界数据中提取步态速度、步幅规律、行走时间和总回合的指标。
在现实世界的步态速度和步幅规律与 SDMT、FES-I 和 PDDS 之间均发现了显著相关性。对步态速度和步幅规律进行了向后线性回归分析，在两个指标中都包含 PDDS 和 SDMT。这些变量解释了步态速度的 63%和步幅规律的 69%的方差。在调整年龄和性别后，步态数量的结果不显著。
该研究的结果提供了有关认知、行走障碍和跌倒恐惧对现实世界步行的作用的见解。深入了解这些贡献可以为旨在改善行走的有针对性的干预措施提供信息。此外，步态指标、认知和跌倒恐惧与步态数量之间没有显著相关性，这突出表明需要进一步研究以确定增加该人群行走的因素。
