Test-retest reliability and minimal detectable change of ankle kinematics and spatiotemporal parameters in MS population
Test-retest reliability and minimal detectable change of ankle kinematics and spatiotemporal parameters in MS population
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DOI：
10.1016/j.gaitpost.2019.09.015
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发表时间：
2019-10-01
期刊：
影响因子：
2.4
通讯作者：
van der Linden, Marietta L.
中科院分区：
文献类型：
--
作者：
Andreopoulou, Georgia;Mahad, Don J.;van der Linden, Marietta L.
背景资料：许多患有多发性硬化症（多发性硬化症）的人经历步行障碍，通常包括足下垂，明显表现为初始接触时和/或步态周期摆动阶段的背屈减少。为了测量踝关节运动学的细微差异，3D步态分析被认为是一个“黄金”标准。然而，踝关节运动学的心理测量特性在MS人口尚未examined.Objective：本研究的目的是检查重测的相对和绝对可靠性的矢状面踝关节运动学和时空参数在两组不同程度的步行impairment.Methods：两组的踝关节运动学进行了3D步态分析，在两个场合7-14天。A组包括21名（14名女性）扩展残疾状态量表（EDSS）1-3.5的受试者，B组包括28名（14名女性）EDSS 4-6的受试者。计算摆动时背屈峰值（DF）、初始接触时踝关节角度（IC）、步态轮廓评分（GPS）、步行速度、步频和步长的组内相关系数（ICC 2，2）、测量标准误（SEM）和最小可检测变化（MDC 95%）。两组均表现出“优秀”的ICC值摆动时的DF、最大和最小患肢的IC和步长、步行速度和步频（> 0.75），两个肢体的GPS表现出“一般”至“良好”ICC（0.489-0.698）。所有踝关节运动学参数的MDC 95%值在A组（1.9度-4.2度）低于组B（2.2度-7.7度）。结论：目前的结果表明，踝关节运动学和时空参数来自三维步态分析是可靠的结果措施，用于MS人群。此外，本研究提供了可靠性指标，可应用于临床决策和旨在治疗MS患者足下垂的研究设计。
Background: Many people with multiple sclerosis (pwMS) experience walking impairments often including foot drop, evident as either reduced dorsiflexion at initial contact and/or at the swing phase of the gait cycle. To measure even subtle differences in ankle kinematics, 3D gait analysis is considered a 'gold' standard. However, the psychometric properties of ankle kinematics in the MS population have not yet been examined.Objective: The aim of the study was to examine test-retest relative and absolute reliability of sagittal ankle kinematics and spatiotemporal parameters in two groups of pwMS with different levels of walking impairment.Methods: Two groups of pwMS underwent 3D gait analysis on two occasions 7-14 days apart. Group A consisted of 21 (14 female) people with Expanded Disability Status Scale (EDSS) 1-3.5 and group B consisted of 28 participants (14 female) with EDSS 4-6. The Intraclass Correlation Coefficient (ICC2,2), standard error of measurement (SEM) and minimal detectable change (MDC95%) were calculated for peak dorsiflexion (DF) in swing, ankle angle at initial contact (IC), gait profile score (GPS), walking speed, cadence and step length.Results: Both groups presented 'excellent' ICC values (> 0.75) for DF in swing, IC and step length of most and least affected limbs, walking speed and cadence, with GPS for both limbs exhibiting 'fair' to 'good' ICCs (0.489-0.698). The MDC95% values for all ankle kinematic parameters in group A were lower (1.9 degrees-4.2 degrees) than those in group B (2.2 degrees-7.7 degrees).Conclusion: The present results suggest that ankle kinematic and spatiotemporal parameters derived from 3D gait analysis are reliable outcome measures to be used in the MS population. Further, this study provides indices of reliability that can be applied to both clinical decision making and in the design of studies aimed at treating foot drop in people with MS.