使用惯性传感器发现早期多发性硬化症患者的细微步态恶化:为期2年的多中心纵向研究
Elisa Gervasoni1, Denise Anastasi1, Rachele Di Giovanni2
1IRCCS Fondazione Don Carlo Gnocchi Onlus, 20148 Milan, Italy.
Sensors (Basel, Switzerland)
|November 25, 2023
概括
纵向研究表明,多发性硬化症患者 (PwMS) 在两年内会出现微妙的步态变化. 仪器步行分析检测了与残疾和感知到的行走困难相关的变化,即使标准测量没有显示差异.
科学领域:
- 神经学 神经学
- 生物医学工程 生物医学工程
- 康复科学 康复科学 康复科学
背景情况:
- 在早期多发性硬化症 (MS) 中,关于步行障碍进展的纵向研究有限.
- 了解步态变化对于管理MS进展和患者生活质量至关重要.
- 目前的残疾评估可能无法捕捉MS患者 (PwMS) 微妙的步态变化.
研究的目的:
- 描述PwMS的步态质量变化,疾病持续时间在2年内≤5年.
- 为了确定步行质量的变化是否与残疾变化相关 (扩展残疾状况尺度 - EDSS).
- 评估步行质量变化与感知到的行走恶化之间的关联 (多发性硬化症行走量-12 - MSWS-12).
主要方法:
- 一项多中心前性队列研究,涉及56名PwMS,在基线和2年后进行评估.
- 参与者在穿着惯性传感器测量步行的规律性,对称性和不稳定性时,进行了六分钟步行测试 (6MWT).
- 收集的数据包括EDSS用于残疾,MSWS-12用于行走感知,以及仪器步行参数.
主要成果:
- 在基线和随访期间的EDSS,6MWT或MSWS-12得分中没有发现显著差异.
- 在增加EDSS得分和更大的前后行走不稳定性之间发现了显著的相关性 (r = 0.34,p = 0.01).
- 在PwMS恶化 (≥0.5 EDSS增加) 的多变量分析显示,中侧步态不稳定性,步态规律性,ML步态对称性和EDSS变化之间的变化存在关联 (R2 = 0.56,p = 0.003).
结论:
- 仪器步行分析检测出在标准神经评估 (EDSS) 中不明显的微妙步行稳定性,规律性和对称性变化.
- 步行质量的变化,特别是不稳定性和规律性,与早期多发性硬化症中残疾恶化有显著的关联.
- 仪器步行指标影响PwMS对其行走能力的看法,强调客观步行评估在日常活动中的重要性.
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