DelMastro Heather M, Robson Abigail, Gromisch Elizabeth S, Campo Marc, Simaitis Laura B, Lo Albert C, Dhari Zaenab, Ruiz Jennifer A
Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, Connecticut, USA.
Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut, USA.
PM R. 2025 Jan;17(1):45-53. doi: 10.1002/pmrj.13234. Epub 2024 Jul 12.
Muscle weakness is common and significantly affects persons with multiple sclerosis (PwMS), with dysfunction in upper limb (UL) muscle groups occurring in approximately 60% of PwMS.
To develop gender-specific regression-based prediction equations, with 95% confidence intervals for maximal bilateral UL isometric strength (shoulder abduction and adduction, wrist flexion and extension) and hand grip strength in PwMS.
Cross-sectional study.
Comprehensive MS center.
256 PwMS.
Not Applicable.
Shoulder abduction and adduction and wrist flexion and extension isometric strength (Biodex System 4 Pro Dynamometer) and hand grip strength (Jamar handheld dynamometer) were measured. Disease characteristics (disability and disease duration) and demographics (age, height, and weight) were collected. Regression-based predictive equations were generated for the UL muscle groups for each gender and limb, using age, height, weight, disability, and disease duration as covariates. Variables were compared between genders using the Mann-Whitney U test. Maximal voluntary contraction (MVC) reference values (mean ± SD) were reported based on age (<30, 30-39, 40-49, 50-59, 60-69 years) and disability (mild, moderate, severe ambulant, and severe nonambulant) for each gender and limb.
Regression-based equations were developed for both genders' strongest and weakest limb, accounting for age, height, weight, disability, and disease duration. MVC was higher in men than women (p < .001) in all muscle groups. Overall, MVC was significantly related to age in 14, height in 5, weight in 6, disability in 14, and disease duration in none of the 20 models.
This is the first study to provide regression-based prediction equations for strongest and weakest MVC of UL muscle groups and demonstrated an inverse relationship between MVC with disability and age. Regression-based reference strength values can help clinicians understand muscular strength along a spectrum of PwMS and can aid in goal setting and education for realistic outcomes.
肌肉无力很常见，对多发性硬化症患者（PwMS）有显著影响，约60%的PwMS患者上肢（UL）肌群存在功能障碍。
建立基于回归分析的性别特异性预测方程，给出PwMS患者双侧UL最大等长肌力（肩部外展和内收、腕部屈曲和伸展）及握力的95%置信区间。
横断面研究。
综合性MS中心。
256例PwMS患者。
不适用。
测量肩部外展和内收、腕部屈曲和伸展等长肌力（Biodex System 4 Pro测力计）及握力（Jamar手持式测力计）。收集疾病特征（残疾程度和病程）及人口统计学数据（年龄、身高和体重）。以年龄、身高、体重、残疾程度和病程作为协变量，为每个性别和肢体的UL肌群生成基于回归分析的预测方程。使用Mann-Whitney U检验比较不同性别之间的变量。报告基于年龄（<30岁、30 - 39岁、40 - 49岁、50 - 59岁、60 - 69岁）和残疾程度（轻度、中度、重度可步行、重度不可步行）的每个性别和肢体的最大自主收缩（MVC）参考值（均值±标准差）。
为男女最强和最弱肢体建立了基于回归分析的方程，纳入了年龄、身高、体重、残疾程度和病程等因素。所有肌肉群中，男性的MVC均高于女性（p < 0.001）。总体而言，在20个模型中，有14个模型的MVC与年龄显著相关，5个与身高显著相关，6个与体重显著相关，14个与残疾程度显著相关，与病程均无显著相关性。
这是第一项为UL肌群最强和最弱MVC提供基于回归分析的预测方程的研究，证明了MVC与残疾程度和年龄呈负相关。基于回归分析的参考强度值可帮助临床医生了解PwMS患者不同阶段的肌肉力量，并有助于设定目标和开展关于实际预后的教育。
