Balance, gait, and falls in multiple sclerosis
Balance, gait, and falls in multiple sclerosis
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DOI：
10.1016/b978-0-444-63916-5.00015-x
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发表时间：
2018-01-01
期刊：
影响因子：
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通讯作者：
Nilsagard, Ylva
中科院分区：
文献类型：
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作者：
Cameron, Michelle H.;Nilsagard, Ylva
多发性硬化症（MS）是一种中枢神经系统（CNS）的慢性疾病，是全球年轻人中最普遍的非创伤性致残原因。多发性硬化症发生在所有年龄、种族和民族的人群中。多发性侧索硬化症的特点是临床症状由脑、脊髓或视神经病变引起，可影响平衡、步态和跌倒风险。随着时间的推移，病变会累积并发生在中枢神经系统的不同区域，引起虚弱、痉挛和疲劳等症状，以及感觉、协调、视觉、认知和膀胱功能的变化。因此，不平衡、步态功能障碍和跌倒在ms患者中很常见也就不足为奇了。绝大多数患者甚至在病程早期就有姿势控制和步态异常。总的来说，50-80%的人有平衡和步态障碍，超过50%的人每年至少跌倒一次。MS中的平衡功能障碍被定义为三个相互关联的问题：保持位置的能力下降，运动受限和缓慢，以及对姿势移位和扰动的反应延迟。此外，功能平衡表现可能受到双重任务整合受损的影响。MS患者的行走变化包括步态速度降低、行走平衡受损以及与行走相关的体力活动减少。多发性硬化症患者的跌倒与受伤、减少参与和增加对跌倒的恐惧有关。越来越多的康复和医疗干预措施可用于解决与MS相关的平衡、步态和跌倒风险的变化。
Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS) and the most widespread nontraumatic cause of disability in young adults around the world. MS occurs in people of all ages, races, and ethnicities. MSis characterized by clinical symptoms resulting from lesions in the brain, spinal cord, or optic nerves that can affect balance, gait, and fall risk. Lesions accumulate over time and occur in different areas of the CNS causing symptoms that include weakness, spasticity, and fatigue, as well as changes in sensation, coordination, vision, cognition, and bladder function. Thus, it is not surprising that imbalance, gait dysfunction, and falls are common in people with MS. The overwhelming majority have abnormalities of postural control and gait even early in the disease course. In all, 50-80% have balance and gait dysfunction and over 50% fall at least once each year. Balance dysfunction in MS is conceptualized as three interrelated problems: decreased ability to maintain position, limited and slowed movement towards limits of stability, and delayed responses to postural displacements and perturbations. In addition, functional balance performance may be affected by impaired dual-task integration. Walking changes in MS include reduced gait speed, impaired walking balance, and reduced walking-related physical activity. Falls in people with MS are associated with injuries, reduced participation, and increased fear of falling. Awide and growing range of rehabilitation and medical interventions are available to address the changes in balance, gait, and fall risk associated with MS.