Heather M DelMastro, Tracy Wall, Deirdre J McPartland, Erik S Plaia, Naomi J Trimble, Jennifer A Ruiz, Katherine Harris, Elizabeth S Gromisch
{"title":"下肢力量是多发性硬化症患者跌倒和非跌倒的区别。","authors":"Heather M DelMastro, Tracy Wall, Deirdre J McPartland, Erik S Plaia, Naomi J Trimble, Jennifer A Ruiz, Katherine Harris, Elizabeth S Gromisch","doi":"10.1016/j.apmr.2025.01.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine whether hip flexion (HF), extension (HE), abduction (HA), knee flexion (KF) and extension (KE), and ankle plantarflexion (APF) and dorsiflexion (ADF) Maximum Voluntary Contraction (MVC) differentiates between non-fall and fall history in persons with MS (PwMS) after accounting for age, gender, fatigue, disability, and disease duration.</p><p><strong>Design: </strong>Secondary analysis of a cross-sectional study.</p><p><strong>Setting: </strong>Community-based comprehensive MS Center PARTICIPANTS: 172 persons with MS who completed a one-time visit INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Lower limb (LL) MVC was measured for each muscle group as isometric peak torque (Newton-meter: Nm) of both limbs (Strongest: S; Weakest: W) using a Biodex Dynamometer and normalized by body weight (Nm/kg). Falls in the past 6-months were retrospectively collected and participants were classified as non-fall history (0 falls [non-fallers]; n = 78) or fall history (≥1 falls [fallers]; n = 94). Fall history was further categorized as occasional (1-2 falls [occasional fallers]; n = 51) and recurrent (≥3 falls [recurrent fallers]; n = 43).</p><p><strong>Results: </strong>Overall differences between participants with and without a fall history were noted on both limbs, with post-hoc analyses showing that those with a fall history had significantly lower strength (p < .05) on all LL-W and HF-S, HE-S, HA-S, KF-S, and APF-S. When separated out by fall frequency, recurrent fallers had diminished strength on all LL-W and HF-S, HE-S, HA-S, and APF-S, while occasional fallers exhibited reductions on HA-W, KE-W, and KF-W compared to non-fallers. Recurrent and occasional fallers differed on HE-W.</p><p><strong>Conclusion: </strong>All LL-W and aspects of LL-S differentiated between fallers and non-fallers, with further differences observed when fall history was separated by frequency. These findings provide the necessary information to clinicians to inform their plans of care to address falls in MS and provide education on the importance of maintaining LL strength.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lower limb strength differentiates between fallers and non-fallers with multiple sclerosis.\",\"authors\":\"Heather M DelMastro, Tracy Wall, Deirdre J McPartland, Erik S Plaia, Naomi J Trimble, Jennifer A Ruiz, Katherine Harris, Elizabeth S Gromisch\",\"doi\":\"10.1016/j.apmr.2025.01.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To determine whether hip flexion (HF), extension (HE), abduction (HA), knee flexion (KF) and extension (KE), and ankle plantarflexion (APF) and dorsiflexion (ADF) Maximum Voluntary Contraction (MVC) differentiates between non-fall and fall history in persons with MS (PwMS) after accounting for age, gender, fatigue, disability, and disease duration.</p><p><strong>Design: </strong>Secondary analysis of a cross-sectional study.</p><p><strong>Setting: </strong>Community-based comprehensive MS Center PARTICIPANTS: 172 persons with MS who completed a one-time visit INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Lower limb (LL) MVC was measured for each muscle group as isometric peak torque (Newton-meter: Nm) of both limbs (Strongest: S; Weakest: W) using a Biodex Dynamometer and normalized by body weight (Nm/kg). Falls in the past 6-months were retrospectively collected and participants were classified as non-fall history (0 falls [non-fallers]; n = 78) or fall history (≥1 falls [fallers]; n = 94). Fall history was further categorized as occasional (1-2 falls [occasional fallers]; n = 51) and recurrent (≥3 falls [recurrent fallers]; n = 43).</p><p><strong>Results: </strong>Overall differences between participants with and without a fall history were noted on both limbs, with post-hoc analyses showing that those with a fall history had significantly lower strength (p < .05) on all LL-W and HF-S, HE-S, HA-S, KF-S, and APF-S. When separated out by fall frequency, recurrent fallers had diminished strength on all LL-W and HF-S, HE-S, HA-S, and APF-S, while occasional fallers exhibited reductions on HA-W, KE-W, and KF-W compared to non-fallers. Recurrent and occasional fallers differed on HE-W.</p><p><strong>Conclusion: </strong>All LL-W and aspects of LL-S differentiated between fallers and non-fallers, with further differences observed when fall history was separated by frequency. These findings provide the necessary information to clinicians to inform their plans of care to address falls in MS and provide education on the importance of maintaining LL strength.</p>\",\"PeriodicalId\":8313,\"journal\":{\"name\":\"Archives of physical medicine and rehabilitation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-01-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of physical medicine and rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.apmr.2025.01.001\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.apmr.2025.01.001","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Lower limb strength differentiates between fallers and non-fallers with multiple sclerosis.
Objective: To determine whether hip flexion (HF), extension (HE), abduction (HA), knee flexion (KF) and extension (KE), and ankle plantarflexion (APF) and dorsiflexion (ADF) Maximum Voluntary Contraction (MVC) differentiates between non-fall and fall history in persons with MS (PwMS) after accounting for age, gender, fatigue, disability, and disease duration.
Design: Secondary analysis of a cross-sectional study.
Setting: Community-based comprehensive MS Center PARTICIPANTS: 172 persons with MS who completed a one-time visit INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Lower limb (LL) MVC was measured for each muscle group as isometric peak torque (Newton-meter: Nm) of both limbs (Strongest: S; Weakest: W) using a Biodex Dynamometer and normalized by body weight (Nm/kg). Falls in the past 6-months were retrospectively collected and participants were classified as non-fall history (0 falls [non-fallers]; n = 78) or fall history (≥1 falls [fallers]; n = 94). Fall history was further categorized as occasional (1-2 falls [occasional fallers]; n = 51) and recurrent (≥3 falls [recurrent fallers]; n = 43).
Results: Overall differences between participants with and without a fall history were noted on both limbs, with post-hoc analyses showing that those with a fall history had significantly lower strength (p < .05) on all LL-W and HF-S, HE-S, HA-S, KF-S, and APF-S. When separated out by fall frequency, recurrent fallers had diminished strength on all LL-W and HF-S, HE-S, HA-S, and APF-S, while occasional fallers exhibited reductions on HA-W, KE-W, and KF-W compared to non-fallers. Recurrent and occasional fallers differed on HE-W.
Conclusion: All LL-W and aspects of LL-S differentiated between fallers and non-fallers, with further differences observed when fall history was separated by frequency. These findings provide the necessary information to clinicians to inform their plans of care to address falls in MS and provide education on the importance of maintaining LL strength.
期刊介绍：
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
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