Multiple Sclerosis and Postural Control: The Role of Spasticity
Multiple Sclerosis and Postural Control: The Role of Spasticity
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DOI：
10.1016/j.apmr.2009.09.013
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发表时间：
2010-01-01
影响因子：
4.3
通讯作者：
Motl, Robert W.
中科院分区：
文献类型：
--
作者：
Sosnoff, Jacob J.;Shin, Sunghoon;Motl, Robert W.
Sosnoff JJ，Shin S.Motl RW.多发性硬化症与姿势控制：痉挛的作用。ARCH Phys Med Rehabil 2010：91：93-9目的：研究多发性硬化症(MS)患者痉挛状态与姿势控制的关系。设计：横断面研究。地点：运动控制实验室。参与者：多发性硬化症患者(n=16，男性2人)和年龄性别匹配的受试者(n=16)。所有MS患者的扩展残疾状态量表评分在0~4.5之间，改良的Ashworth量表评分在1~3之间。干预：不适用。主要观察指标：姿势控制测量用力平台，量化地面反作用力和前后方向的力矩。姿势控制以前后摆动范围、内侧摆动范围、压力中心偏差的95%椭圆形面积、COP摆动速度和包含95%频谱的频率为指标。MS患者进一步接受比目鱼肌Hoffman反射(H反射)作为痉挛指标的评估。结果：对H反射数据的聚类分析确定了MS参与者的高痉挛组(n=7)和低痉挛组(n=9)。在年龄、MS病程和疾病严重程度方面，MS组之间没有差异。前后摆动范围在任何一组之间均无差异。与低痉挛和对照组相比，高痉挛组的COP面积、速度和内侧摆动更大，而低痉挛组的姿势控制值介于高痉挛组和对照组之间。结论：结果表明，痉挛与MS的姿势缺陷有关。
Sosnoff JJ, Shin S. Motl RW. Multiple sclerosis and postural control: the role of spasticity. Arch Phys Med Rehabil 2010:91:93-9.Objectives: To examine the association between spasticity and postural control in subjects with multiple sclerosis (MS).Design: Cross-sectional.Setting: Motor control laboratory.Participants: Subjects with MS (n=16, 2 male) and age and sex-matched subjects (n=16) participated in the investigation. All subjects with MS had Expanded Disability Status Scale scores between 0 and 4.5 and modified Ashworth scale scores between 1 and 3.Interventions: Not applicable.Main Outcome Measures: Postural control was measured with a force platform that quantifies ground reaction forces and moments in mediolateral and anteroposterior directions. Postural control was indexed with anterior-posterior sway range, medial-lateral sway range, 95% elliptical area of the deviations of center of pressure (COP), velocity of COP sway, and the frequency at which 95% of spectral profile was contained. Participants with MS further underwent assessment of the soleus Hoffman reflex (H-reflex) as an index of spasticity.Results: Cluster analysis on H-reflex data identified groups of MS participants with high spasticity (n=7) and low spasticity (n=9). There were no differences in age, duration of MS, and disease severity between MS groups. There were no differences in anterior-posterior sway range between any of the groups. The high spasticity group had greater COP area, velocity, and mediolateral sway compared with the low spasticity and control group, and the low spasticity group had postural control values between the high spasticity and control groups.Conclusions: The pattern of results suggests that spasticity contributes to postural deficits observed in MS.