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急性颈脊髓损伤步态功能的时间动态变化。

Temporal dynamics of gait function in acute cervical spinal cord injury.

机构信息

Department of Orthopaedic Surgery, Japan Organization of Occupational Health and Safety, Spinal Injuries Center, Fukuoka, Japan.

Department of Orthopaedic Surgery, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido, 78-8510, Japan.

出版信息

BMC Musculoskelet Disord. 2024 Jun 3;25(1):430. doi: 10.1186/s12891-024-07551-6.

Abstract

BACKGROUND

Following spinal cord injury (SCI), gait function reaches a post-recovery plateau that depends on the paralysis severity. However, the plateau dynamics during the recovery period are not known. This study aimed to examine the gait function temporal dynamics after traumatic cervical SCI (CSCI) based on paralysis severity.

METHODS

This retrospective cohort study included 122 patients with traumatic CSCI admitted to a single specialized facility within 2 weeks after injury. The Walking Index for Spinal Cord Injury II (WISCI II) was estimated at 2 weeks and 2, 4, 6, and 8 months postinjury for each American Spinal Injury Association Impairment Scale (AIS) grade, as determined 2 weeks postinjury. Statistical analysis was performed at 2 weeks to 2 months, 2-4 months, 4-6 months, and 6-8 months, and the time at which no significant difference was observed was considered the time at which the gait function reached a plateau.

RESULTS

In the AIS grade A and B groups, no significant differences were observed at any time point, while in the AIS grade C group, the mean WISCI II values continued to significantly increase up to 6 months. In the AIS grade D group, the improvement in gait function was significant during the entire observation period.

CONCLUSIONS

The plateau in gait function recovery was reached at 2 weeks postinjury in the AIS grade A and B groups and at 6 months in the AIS grade C group.

摘要

背景

脊髓损伤(SCI)后,步态功能达到依赖瘫痪严重程度的恢复后平台期。然而,恢复期平台期的动态变化尚不清楚。本研究旨在根据瘫痪严重程度检查创伤性颈髓 SCI(CSCI)后的步态功能时间动态变化。

方法

本回顾性队列研究纳入了 122 名在损伤后 2 周内入住单一专门机构的创伤性 CSCI 患者。根据损伤后 2 周时的美国脊髓损伤协会损伤分级(AIS),在损伤后 2 周、2、4、6 和 8 个月时估计脊髓损伤步行指数 II(WISCI II)。在 2 周到 2 个月、2-4 个月、4-6 个月和 6-8 个月进行统计学分析,观察到无显著差异的时间被认为是步态功能达到平台期的时间。

结果

在 AIS 分级 A 和 B 组中,任何时间点均无显著差异,而在 AIS 分级 C 组中,WISCI II 的平均值持续显著增加至 6 个月。在 AIS 分级 D 组中,整个观察期间步态功能的改善均具有统计学意义。

结论

AIS 分级 A 和 B 组的步态功能恢复平台期在损伤后 2 周达到,AIS 分级 C 组在 6 个月达到。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd51/11145767/5c5e671ab075/12891_2024_7551_Fig1_HTML.jpg

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