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一项德尔菲研究,旨在确定多发性硬化症患者的关键步态模式及其潜在原因。

A Delphi study to identify key gait patterns and their potential causes in people with multiple sclerosis.

作者信息

Timmermans Sjoerd T, Van der Krogt Marjolein M, Rietberg Marc B, Beckerman Heleen, De Groot Vincent

机构信息

Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, The Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands; MS Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, The Netherlands.

Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, The Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands.

出版信息

J Rehabil Med. 2025 Jun 3;57:jrm42556. doi: 10.2340/jrm.v57.42556.

Abstract

OBJECTIVE

This study aims to identify characteristic gait patterns in people with multiple sclerosis, to describe their key characteristics, and to identify their potential underlying causes.

DESIGN

a 3-round Delphi study.

PARTICIPANTS

An international panel of 20 experts, including physiotherapists, a neurologist, rehabilitation physicians, biomechanical engineers, and movement scientists with expertise in multiple sclerosis or gait analysis.

METHODS

A comprehensive list of gait characteristics and underlying impairments was compiled and analysed to identify common gait patterns and their primary features and potential causes. Consensus was defined as 67% agreement.

RESULTS

Consensus was reached on 6 gait patterns in multiple sclerosis: (i) drop foot; (ii) insufficient push-off; (iii) stiff knee during swing; (iv) knee hyperextension during stance; (i) knee flexion in midstance; and (vi) enhanced gait variability. At least 69% agreement was achieved on the naming of the final gait patterns, their key characteristics, and the potential causes of each pattern.

CONCLUSION

Consensus was achieved on 6 gait patterns, their characteristics, and potential underlying causes. The identification of these gait patterns may support clinical decision-making regarding diagnostic and treatment measures, and deepen understanding of impairments that underlie walking problems in people with multiple sclerosis.

摘要

目的

本研究旨在识别多发性硬化症患者的特征性步态模式,描述其关键特征,并确定其潜在的根本原因。

设计

三轮德尔菲研究。

参与者

由20名专家组成的国际小组,包括物理治疗师、神经科医生、康复医生、生物力学工程师以及在多发性硬化症或步态分析方面具有专业知识的运动科学家。

方法

编制并分析了一份步态特征和潜在损伤的综合清单,以确定常见的步态模式及其主要特征和潜在原因。共识定义为67%的一致意见。

结果

就多发性硬化症的6种步态模式达成了共识:(i)足下垂;(ii)蹬离不足;(iii)摆动期膝关节僵硬;(iv)站立期膝关节过度伸展;(i)站立中期膝关节屈曲;以及(vi)步态变异性增强。在最终步态模式的命名、其关键特征以及每种模式的潜在原因方面,至少达成了69%的一致意见。

结论

就6种步态模式、其特征和潜在的根本原因达成了共识。识别这些步态模式可能有助于支持关于诊断和治疗措施的临床决策,并加深对多发性硬化症患者行走问题背后损伤的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52ba/12159873/006897b2f3bc/JRM-57-42556-g001.jpg

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