Profiling walking dysfunction in multiple sclerosis: characterisation, classification and progression over time.
Profiling walking dysfunction in multiple sclerosis: characterisation, classification and progression over time.
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DOI：
10.1038/s41598-018-22676-0
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发表时间：
2018-03-21
影响因子：
4.6
通讯作者：
Zörner B
中科院分区：
文献类型：
--
作者：
Filli L;Sutter T;Easthope CS;Killeen T;Meyer C;Reuter K;Lörincz L;Bolliger M;Weller M;Curt A;Straumann D;Linnebank M;Zörner B
步态障碍是多发性硬化症（MS）常见的相关症状。本研究旨在通过全面的3D步态分析和临床步行测试来描述MS步态受损患者的步态病理学。37名多发性硬化症患者以他们个人的可持续速度在跑步机上行走，而20名健康对照者以所有不同患者的速度行走，允许独立于行走速度的比较。运动学分析显示，患者的膝关节和踝关节运动明显受限，步态变异性和不对称性增加，同时动态稳定性受损。最具鉴别性的单一步态参数是膝关节活动范围减小，将患者与对照组区分开来的准确率为83.3% （χ2检验；p = 0.0001）。基于层次聚类和主成分分析，确定了三种主要的病理步态模式：痉挛性麻痹、类共济失调和不稳定步态。1年后的随访评估显示行走功能恶化，特别是在患有痉挛性麻痹步态模式的患者中。我们的研究结果表明，膝关节/踝关节控制受损在多发性硬化症患者中很常见。个性化的步态特征和聚类算法可能是对患者进行分层和为患者量身定制锻炼计划的有前途的工具。在多发性硬化症试验中，反应灵敏、客观的结果测量对于监测疾病进展和治疗效果非常重要。
Gait dysfunction is a common and relevant symptom in multiple sclerosis (MS). This study aimed to profile gait pathology in gait-impaired patients with MS using comprehensive 3D gait analysis and clinical walking tests. Thirty-seven patients with MS walked on the treadmill at their individual, sustainable speed while 20 healthy control subjects walked at all the different patient’s paces, allowing for comparisons independent of walking velocity. Kinematic analysis revealed pronounced restrictions in knee and ankle joint excursion, increased gait variability and asymmetry along with impaired dynamic stability in patients. The most discriminative single gait parameter, differentiating patients from controls with an accuracy of 83.3% (χ2 test; p = 0.0001), was reduced knee range of motion. Based on hierarchical cluster and principal component analysis, three principal pathological gait patterns were identified: a spastic-paretic, an ataxia-like, and an unstable gait. Follow-up assessments after 1 year indicated deterioration of walking function, particularly in patients with spastic-paretic gait patterns. Our findings suggest that impaired knee/ankle control is common in patients with MS. Personalised gait profiles and clustering algorithms may be promising tools for stratifying patients and to inform patient-tailored exercise programs. Responsive, objective outcome measures are important for monitoring disease progression and treatment effects in MS trials.
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影响因子：
4.6
作者：
Broom L;Ellison BA;Worley A;Wagenaar L;Sörberg E;Ashton C;Bennett DA;Buchman AS;Saper CB;Shih LC;Hausdorff JM;VanderHorst VG
通讯作者：
VanderHorst VG
影响因子：
2.4
作者：
Campanini, I.;Merlo, A.;Damiano, B.
通讯作者：
Damiano, B.
影响因子：
14.5
作者：
Filli, Linard;Zoerner, Bjoern;Schwab, Martin E.
通讯作者：
Schwab, Martin E.
影响因子：
5.8
作者：
Crenshaw, S. J.;Royer, T. D.;Hudson, D. J.
通讯作者：
Hudson, D. J.
影响因子：
5.8
作者：
Broekmans, Tom;Gijbels, Domien;Feys, Peter
通讯作者：
Feys, Peter