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Mobility Disorders in Stroke, Parkinson Disease, and Multiple Sclerosis: A Multicenter Cross-Sectional Study.

卒中、帕金森病和多发性硬化症中的行动障碍: 一项多中心横断面研究。

  • 影响因子:1.55
  • DOI:10.1097/PHM.0000000000001272
  • 作者列表:"Cattaneo D","Gervasoni E","Pupillo E","Bianchi E","Aprile I","Imbimbo I","Russo R","Cruciani A","Jonsdottir J","Agostini M","Beghi E","NEUROFALL Group.
  • 发表时间:2020-01-01
Abstract

OBJECTIVE:The aims of the study were to compare mobility in multiple sclerosis, Parkinson disease, and stroke, and to quantify the relationship between mobility and participation restrictions. DESIGN:This is a multicenter cross-sectional study. Included were compliant subjects with Parkinson disease, multiple sclerosis, and stroke seen for rehabilitation, with no comorbidities interfering with mobility. Functional scales were applied to each subject to investigate gait speed (10-meter walking test), balance while maintaining body position (Berg Balance Scale), dynamic balance and mobility (Timed Up and Go and Dynamic Gait Index), and participation (Community Integration Questionnaire). RESULTS:Two hundred ninety-nine patients (111 multiple sclerosis, 94 Parkinson disease, and 94 stroke) were enrolled. Stroke had the slowest gait speed (mean gait speed = 0.9 m/sec) compared with Parkinson disease (1.1 m/sec), and multiple sclerosis (1.2 m/sec) (P < 0.001). Multiple sclerosis was more limited than Parkinson disease and stroke in dynamic balance both in the Timed Up and Go Test (multiple sclerosis = 16.7 secs, Parkinson disease = 11.4 secs, stroke = 14.0 secs; P < 0.001) and Dynamic Gait Index (multiple sclerosis = 11.6 points, Parkinson disease = 12.9 points, stroke = 13.6 points; P = 0.03); ability to maintain balance and body position (Berg Balance Scale) was more affected in stroke and Parkinson disease than multiple sclerosis (multiple sclerosis = 42.6 points, Parkinson disease = 39.4 points, stroke = 39.7 points; P = 0.03). Balance disorders were associated with participation restrictions but not gait speed. CONCLUSIONS:Neurological conditions have differing impacts on gait and balance, leading to different levels of participation restriction.

摘要

目的: 这项研究的目的是比较多发性硬化症、帕金森病和中风患者的流动性,并量化流动性和参与限制之间的关系。 设计: 这是一项多中心横断面研究。纳入的是符合标准的帕金森病、多发性硬化症和中风康复治疗的受试者,无合并症干扰活动能力。对每个受试者应用功能量表调查步态速度 (10 米步行test、保持体位时的平衡 (Berg平衡量表) 、动态平衡和活动能力 (计时上升和去和动态步态指数),以及参与度 (社区整合问卷)。 结果: 入选了 2 900 例患者 (111 例多发性硬化症,94 例帕金森病和 94 例卒中)。与帕金森病 (0.9 米/秒) 和多发性硬化 (1.1 米/秒) 相比,中风的步态速度最慢 (平均步态速度 = 1.2 米/秒) (P <0.001)。在Timed Up和Go测试中,多发性硬化在动态平衡方面比帕金森病和卒中更有限 (多发性硬化 = 16.7 秒,帕金森病 = 11.4 秒,卒中 = 14.0 秒; P < 0.001) 和动态步态指数 (多发性硬化 = 11.6 分,帕金森病 = 12.9 分,中风 = 13.6 分; P = 0.03); 保持平衡和体位的能力 (Berg平衡量表) 在中风和帕金森病中的影响大于多发性硬化症 (多发性硬化 = 42.6 分,帕金森病 = 39.4 分,中风 = 39.7 分; P = 0.03)。平衡障碍与参与限制有关,但与步态速度无关。 结论: 神经系统疾病对步态和平衡有不同的影响,导致不同程度的参与限制。

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影响因子:1.55
发表时间:2020-01-01
DOI:10.1097/PHM.0000000000001264
作者列表:["Gutiérrez-Cruz C","Rojas Ruiz FJ","De La Cruz Marquez JC","Gutiérrez-Davila M"]

METHODS:PURPOSE:The aim of the study was to assess dual-task cost to spatio-temporal gait parameters in people with multiple sclerosis and a matched control group. METHOD:The multiple sclerosis group was composed of 17 participants with a diagnosis of multiple sclerosis and an Expanded Disability Status Scale score of less than 6. A total of 17 healthy participants were allocated to the control group by stratification. Controls were matched on the basis of age, sex, sociocultural habits, and body structure. Dual-task cost was determined by within-group repeated-measures analysis of variance. Participants were instructed to ambulate under normal conditions and perform a discrimination and decision-making task concurrently. Then, between-group analysis of variance was used to assess differences in mean dual-task cost between groups and determine dual-task cost differential. Testing was performed using three-dimensional photogrammetry and an electronic walkway. RESULTS:Based on dual-task cost differential, gait cycle time increase (-5.8%) and gait speed decrease (6.3%) because of multiple sclerosis-induced impairment. CONCLUSIONS:During single- and dual-task conditions, gait speed was lower in multiple sclerosis participants, because of a shorter step length and increased swing time. Increased gait time might be the result of compensatory mechanisms adopted to maintain stability while walking specially during the double-support phases.

关键词: 暂无
翻译标题与摘要 下载文献
影响因子:1.55
发表时间:2020-01-01
DOI:10.1097/PHM.0000000000001272
作者列表:["Cattaneo D","Gervasoni E","Pupillo E","Bianchi E","Aprile I","Imbimbo I","Russo R","Cruciani A","Jonsdottir J","Agostini M","Beghi E","NEUROFALL Group."]

METHODS:OBJECTIVE:The aims of the study were to compare mobility in multiple sclerosis, Parkinson disease, and stroke, and to quantify the relationship between mobility and participation restrictions. DESIGN:This is a multicenter cross-sectional study. Included were compliant subjects with Parkinson disease, multiple sclerosis, and stroke seen for rehabilitation, with no comorbidities interfering with mobility. Functional scales were applied to each subject to investigate gait speed (10-meter walking test), balance while maintaining body position (Berg Balance Scale), dynamic balance and mobility (Timed Up and Go and Dynamic Gait Index), and participation (Community Integration Questionnaire). RESULTS:Two hundred ninety-nine patients (111 multiple sclerosis, 94 Parkinson disease, and 94 stroke) were enrolled. Stroke had the slowest gait speed (mean gait speed = 0.9 m/sec) compared with Parkinson disease (1.1 m/sec), and multiple sclerosis (1.2 m/sec) (P < 0.001). Multiple sclerosis was more limited than Parkinson disease and stroke in dynamic balance both in the Timed Up and Go Test (multiple sclerosis = 16.7 secs, Parkinson disease = 11.4 secs, stroke = 14.0 secs; P < 0.001) and Dynamic Gait Index (multiple sclerosis = 11.6 points, Parkinson disease = 12.9 points, stroke = 13.6 points; P = 0.03); ability to maintain balance and body position (Berg Balance Scale) was more affected in stroke and Parkinson disease than multiple sclerosis (multiple sclerosis = 42.6 points, Parkinson disease = 39.4 points, stroke = 39.7 points; P = 0.03). Balance disorders were associated with participation restrictions but not gait speed. CONCLUSIONS:Neurological conditions have differing impacts on gait and balance, leading to different levels of participation restriction.

关键词: 暂无
翻译标题与摘要 下载文献
影响因子:2.61
发表时间:2020-01-01
DOI:10.1111/ane.13152
作者列表:["Ferraro D","Guicciardi C","De Biasi S","Pinti M","Bedin R","Camera V","Vitetta F","Nasi M","Meletti S","Sola P"]

METHODS:OBJECTIVES:Cerebrospinal fluid (CSF) and blood neurofilaments (NFLs) are markers of axonal damage and are being investigated, mostly in relapsing-remitting (RR) MS, as a marker of disease activity and of response to treatment, while there are less data in progressive MS patients. Primary aim was to measure NFL in plasma samples of untreated patients with primary (PP) and secondary (SP) progressive MS and to correlate them with disability, disease severity, and prior/subsequent disability progression. MATERIALS AND METHODS:Neurofilament concentrations were measured using SIMOA (Single Molecule Array, Simoa HD-1 Analyzer; Quanterix). RESULTS:Neurofilament concentrations were measured on plasma samples of 70 progressive (27 PP and 43 SP), 21 RRMS patients, and 10 HCs. Longitudinal plasma NFL (pNFL) concentrations (median interval between sampling: 25 months) were available for nine PP/SP patients. PNFL concentrations were significantly higher in PP/SP compared to RRMS patients. They correlated with EDSS and MS Severity Score values. There was no difference in pNFL levels between PP/SP patients with EDSS progression in the preceding year (14% of patients) or during a median follow-up of 27 months (41%). In the longitudinal sub-study, pNFL levels increased in all patients between sampling by a mean value of 23% while EDSS mostly remained stable (77% of cases). CONCLUSION:In PP/SP progressive MS patients, pNFL levels correlate with disability and increase over time, but are not associated with prior/subsequent disability progression, as measured by EDSS, which may not be a sufficiently sensitive tool in this context.

脱髓鞘疾病方向

急性发作或亚急性损害神经中枢的疾病,发病高峰为二到三周,若治疗延误受损神经继发缺血变性则发生多发性硬化,发病严重时可侵犯脊髓前角细胞和脑干神经核以及大脑运动皮质锥体细胞危及生命,多为基因免疫异常或病毒感染所致。

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