超越EDSS:多领域障碍可检测,并与患有多发性硬化症的低残疾人的行走障碍相关
Elisa Gervasoni1, Alessandro Torchio1, Rita Bertoni1
1IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Journal of neurology
|May 17, 2025
概括
多发性硬化症 (MS) 的微妙损伤甚至在低残疾人中也很常见. 力量和疲劳显著影响行走能力,突出了MS患者需要敏感评估的需要.
科学领域:
- 神经学 神经学
- 康复医学 康复医学 康复医学
- 临床评估 临床评估
背景情况:
- 多发性硬化症 (MS) 呈现出各种障碍,在残疾最小的个体中通常是微妙的和被忽视的.
- 精确评估这些微妙的缺陷对于监测MS患者的疾病进展和治疗疗效至关重要.
研究的目的:
- 调查微弱残疾PwMS中多领域障碍的患病率.
- 确定这些障碍与行走障碍之间的关联.
主要方法:
- 一项涉及80名PwMS的横截面研究,其扩展残疾状况量表 (EDSS) 分数为<2.5.
- 综合性评估包括EDSS功能评分,下肢强度 (跳),触觉灵敏度 (单丝测试),平衡,疲劳 (疲劳严重程度量表) 和认知功能 (符号数字模式测试).
- 使用6分钟步行测试 (6MWT) 和MS步行尺度-12 (MSWS-12) 测量了步行能力.
主要成果:
- 超过50%的PwMS患者表现出金字塔功能障碍,超过20%的患者有感官缺陷.
- 30%的下肢强度下降,20-40%的触觉受损,9-26%报告疲劳增加.
- 虽然EDSS得分适度预测走路障碍,但下肢强度和疲劳是更强的预测因素.
结论:
- 微弱残疾的PwMS经历了显著的多领域障碍.
- 敏感的临床评估对于早期发现微妙缺陷至关重要.
- 基于早期识别的有针对性的干预措施可以改善PwMS中的流动性.
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