Manifestations of walking fatigability in people with multiple sclerosis based on gait quality and distance walked during the six minutes walking test

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-09-25 DOI:10.1016/j.msard.2024.105909

Felipe Balistieri Santinelli , Zuhal Abasıyanık , Cintia Ramari , Griet Gysemberg , Daphne Kos , Massimiliano Pau , Alon Kalron , Pieter Meyns , Serkan Ozakbas , Peter Feys

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引用次数: 0

Abstract

Background

Distance walking fatigability (DWF) in people with multiple sclerosis (pwMS) is defined as a decrease in the distance walking over time. However, declines in gait quality (i.e., gait quality fatigability- GQF) may occur independently or alongside DWF.

Objective

i) to investigate how walking fatigability manifests and its prevalence in pwMS; ii) to describe the temporal pattern of the changes of specific gait characteristics during the 6-minute walking test (6MWT)

Methods

Eighty-eight pwMS (EDSS 4[0–6.5], 49[21–70] years) and 47 healthy controls (HC- 46[25–60] years) performed the 6MWT wearing inertial measurement units. Gait characteristics (stride length, sensor-based gait speed, cadence, double support, step duration, stance phase, step duration asymmetry, step duration variability, foot-strike, toe-off, and leg circumduction) and walking distance were recorded in 1-minute intervals. A fatigability index was calculated by comparing the last and first minute of the 6MWT to identify abnormal worsening based on cutoff scores. The manifestation of walking fatigability was counted. The temporal pattern of worsening of gait characteristics during the 6MWT was examined in pwMS exceeding the cutoff values, compared to pwMS without abnormal changes and HC, using a two-way ANOVA (group vs. minutes)

Results

Thirty-five pwMS presented both DWF and GQF, 2 presented isolated DWF, 27 presented isolated GQF, and 24 presented non-walking fatigability. PwMS having GQF presented worsening in gait characteristics (cadence, step duration, step duration variability, or toe-off angle) from minute 2 onwards of the 6MWT, while HCs and pwMS without abnormal changes stabilized gait from minute 2 towards the end of the 6MWT.

Conclusion

Walking fatigability in pwMS manifests not only as a decrease in walking distance but also as changes in gait quality. Understanding changes in gait characteristics during walking can help tailor rehabilitation interventions.

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根据步态质量和六分钟步行测试中的步行距离来判断多发性硬化症患者的步行疲劳表现。

背景：多发性硬化症患者（pwMS）的步行距离疲劳（DWF）是指步行距离随时间推移而减少。然而，步态质量的下降（即目标：i）研究行走疲劳在多发性硬化症患者中的表现形式和发生率；ii）描述 6 分钟行走测试（6MWT）中特定步态特征变化的时间模式方法：88 名多发性硬化症患者（EDSS 4[0-6。5]，49[21-70]岁）和 47 名健康对照组（HC- 46[25-60]岁）佩戴惯性测量装置进行了 6MWT 测试。以 1 分钟为间隔记录步态特征（步长、基于传感器的步速、步幅、双支撑、步长、步态阶段、步长不对称性、步长变异性、蹬脚、脚尖离开和腿部外展）和步行距离。通过比较 6MWT 的最后一分钟和第一分钟，计算出疲劳指数，从而根据临界分数确定异常恶化情况。对行走疲劳的表现进行计数。与无异常变化的 pwMS 和 HC 相比，采用双向方差分析（组别 vs. 分钟）研究了超过临界值的 pwMS 在 6MWT 期间步态特征恶化的时间模式。从 6MWT 第 2 分钟开始，出现 GQF 的 pwMS 的步态特征（步幅、步长、步长变异性或脚尖离开角度）有所恶化，而 HCs 和无异常变化的 pwMS 在 6MWT 第 2 分钟结束时步态趋于稳定：结论：pwMS 的步行疲劳不仅表现为步行距离的减少，还表现为步态质量的变化。了解步行过程中步态特征的变化有助于制定康复干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.