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Associations of lower limb joint asymmetry with fatigue and disability in people with multiple sclerosis.
Clinical Biomechanics ( IF 1.8 ) Pub Date : 2020-03-11 , DOI: 10.1016/j.clinbiomech.2020.104989 Craig D Workman 1 , Alexandra C Fietsam 1 , Thorsten Rudroff 2
Clinical Biomechanics ( IF 1.8 ) Pub Date : 2020-03-11 , DOI: 10.1016/j.clinbiomech.2020.104989 Craig D Workman 1 , Alexandra C Fietsam 1 , Thorsten Rudroff 2
Affiliation
BACKGROUND
An early symptom of multiple sclerosis is unilateral weakness, particularly in the lower limbs, which is associated with strength asymmetries. The purpose of this exploratory study was to examine strength asymmetries at the hip, knee, and ankle joints, and to investigate the associations between lower limb strength asymmetries and self-reported fatigue severity and disability in people with multiple sclerosis.
METHODS
Sixteen mildly-disabled people with multiple sclerosis (females = 9) completed isokinetic maximal voluntary contractions of the hip extensors and flexors, knee extensors and flexors, and ankle plantar flexors and dorsiflexors. Asymmetry indices between the strength of the more- and less-affected lower limbs at each muscle group and the percent agreement between self-reported and objectively-determined more-affected lower limb were calculated. Patient Determined Diseases Steps and Fatigue Severity Scale were also completed.
FINDINGS
All joints showed asymmetry (asymmetry indices ≥10%). Knee flexors (mean [SD]; 49.9 [37.8%]) and ankle plantar flexors (46.6 [35.5%]) had the largest asymmetry indices. Hip and knee extensors had the lowest asymmetry indices (21.1 [18.1%] and 30.1 [24.7%], respectively) and the highest agreement between self-reported and objectively-determined more-affected lower limb (93.3 and 93.8, respectively). The hip extensor asymmetry index was correlated with the Fatigue Severity Scale (r = 0.542, p = 0.037).
INTERPRETATION
For the assessment of strength asymmetries in people with multiple sclerosis, it is suggested to 1) include measures of hip, knee, and ankle strength asymmetries, 2) include subjective perceptions and objective measures of strength asymmetries concurrently, and 3) to include measures of sensory function (proprioception).
中文翻译:
多发性硬化症患者下肢关节不对称与疲劳和残疾的关系。
背景技术多发性硬化症的早期症状是单侧无力,特别是在下肢,这与力量不对称有关。这项探索性研究的目的是检查髋,膝和踝关节的力量不对称性,并研究下肢力量不对称性与多发性硬化症患者自我报告的疲劳严重程度和残疾之间的关系。方法16名患有多发性硬化症的轻度残疾人(女性= 9)完成了髋伸肌和屈肌,膝伸肌和屈肌以及踝an屈和背屈的等速运动最大自愿收缩。计算了每个肌肉组受影响程度较高和较少的下肢强度与自我报告的和客观确定的受影响程度较高的下肢之间的一致性百分比之间的不对称指数。还完成了患者确定的疾病步骤和疲劳严重程度量表。结果所有关节均显示不对称(不对称指数≥10%)。膝屈肌(平均[SD]; 49.9 [37.8%])和踝plant屈(46.6 [35.5%])的不对称指数最大。髋部和膝部伸肌的不对称指数最低(分别为21.1 [18.1%]和30.1 [24.7%]),自我报告的和客观确定的受影响较严重的下肢之间的一致性最高(分别为93.3和93.8)。髋关节伸肌不对称指数与疲劳严重程度评分相关(r = 0.542,p = 0.037)。
更新日期:2020-04-20
中文翻译:
多发性硬化症患者下肢关节不对称与疲劳和残疾的关系。
背景技术多发性硬化症的早期症状是单侧无力,特别是在下肢,这与力量不对称有关。这项探索性研究的目的是检查髋,膝和踝关节的力量不对称性,并研究下肢力量不对称性与多发性硬化症患者自我报告的疲劳严重程度和残疾之间的关系。方法16名患有多发性硬化症的轻度残疾人(女性= 9)完成了髋伸肌和屈肌,膝伸肌和屈肌以及踝an屈和背屈的等速运动最大自愿收缩。计算了每个肌肉组受影响程度较高和较少的下肢强度与自我报告的和客观确定的受影响程度较高的下肢之间的一致性百分比之间的不对称指数。还完成了患者确定的疾病步骤和疲劳严重程度量表。结果所有关节均显示不对称(不对称指数≥10%)。膝屈肌(平均[SD]; 49.9 [37.8%])和踝plant屈(46.6 [35.5%])的不对称指数最大。髋部和膝部伸肌的不对称指数最低(分别为21.1 [18.1%]和30.1 [24.7%]),自我报告的和客观确定的受影响较严重的下肢之间的一致性最高(分别为93.3和93.8)。髋关节伸肌不对称指数与疲劳严重程度评分相关(r = 0.542,p = 0.037)。