Six-Minute Walk Test demonstrates motor fatigue in spinal muscular atrophy
Six-Minute Walk Test demonstrates motor fatigue in spinal muscular atrophy
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DOI：
10.1212/wnl.0b013e3181d3e308
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发表时间：
2010-03-09
期刊：
影响因子：
9.9
通讯作者：
Finkel, R. S.
中科院分区：
文献类型：
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作者：
Montes, J.;McDermott, M. P.;Finkel, R. S.
背景：脊髓性肌萎缩症（SMA）患者的虚弱、耐力下降和疲劳限制了活动能力。已经开发了量表来测量疾病严重程度的广泛范围内的功能。然而，这些量表通常依赖于观察者，评分基于Likert量表项目的总和。六分钟步行试验（6 MWT）是一个客观的，易于管理，和标准化的功能性运动能力的评价，已被证明是可靠的其他神经系统疾病和children.Methods：要研究的性能在SMA的6 MWT，18个门诊参与者进行了评估的横断面研究。临床指标包括6分钟步行时间、10米步行/跑步、哈默史密斯运动功能量表-扩展版（HFMSE）、用力肺活量和手持式测力计。使用斯皮尔曼相关系数分析6 MWT总距离与其他结果之间的关联。结果：6 MWT与HFMSE评分（r = 0.83，p < 0.0001）、10 m步行/跑步（r =-0.87，p <0.0001）和膝屈肌肌力（r = 0.62，p = 0.01）相关。几乎所有参与者的步态速度在连续几分钟内下降。平均第1分钟步行距离（57.5 m）显著大于第6分钟步行距离（48 m）（p = 0.0003）。结论：6分钟步行试验（6 MWT）可安全地应用于非卧床脊髓性肌萎缩症（SMA）患者，与已建立的结局指标相关，对疲劳相关变化敏感。6 MWT是在非卧床SMA受试者中开展的临床试验的一项有前景的候选结局指标。神经病学R 2010; 74：833-838
Background: In spinal muscular atrophy (SMA), weakness, decreased endurance, and fatigue limit mobility. Scales have been developed to measure function across the wide spectrum of disease severity. However, these scales typically are observer dependent, and scores are based on sums across Likert-scaled items. The Six-Minute Walk Test (6MWT) is an objective, easily administered, and standardized evaluation of functional exercise capacity that has been proven reliable in other neurologic disorders and in children.Methods: To study the performance of the 6MWT in SMA, 18 ambulatory participants were evaluated in a cross-sectional study. Clinical measures were 6MWT, 10-m walk/run, Hammersmith Functional Motor Scale-Expanded (HFMSE), forced vital capacity, and handheld dynamometry. Associations between the 6MWT total distance and other outcomes were analyzed using Spearman correlation coefficients. A paired t test was used to compare the mean distance walked in the first and sixth minutes.Results: The 6MWT was associated with the HFMSE score (r = 0.83, p < 0.0001), 10-m walk/run (r = -0.87, p < 0.0001), and knee flexor strength (r = 0.62, p = 0.01). Gait velocity decreased during successive minutes in nearly all participants. The average first minute distance (57.5 m) was significantly more than the sixth minute distance (48 m) (p = 0.0003).Conclusion: The Six-Minute Walk Test (6MWT) can be safely performed in ambulatory patients with spinal muscular atrophy (SMA), correlates with established outcome measures, and is sensitive to fatigue-related changes. The 6MWT is a promising candidate outcome measure for clinical trials in ambulatory subjects with SMA. Neurology r 2010; 74: 833-838