Objective

Gait impairment is the cardinal motor symptom in hereditary spastic paraplegias (HSPs) possibly linked to increased fear of falling and reduced quality of life (QoL). Disease specific symptoms in HSP are rated using the Spastic Paraplegia Rating Scale (SPRS). However, limited studies evaluated more objectively easy-to-apply gait measures by comparing these standardized assessments with patients’ self-perceived impairment and clinically established scores. Therefore, the aim of this study was to correlate functional gait measures with self-rating questionnaires for fear of falling and QoL, and with the SPRS as clinical gold standard.

Methods

HSP patients (“pure” phenotype, n = 22) fulfilling the clinical diagnostic criteria for HSP and age-and gender-matched healthy subjects (n = 22) were included in this study. Motor impairment was evaluated using the SPRS, fear of falling by the Falls Efficacy Scale-International (FES-I), and QoL by SF-12. Functional gait measures included gait speed and step length (10-meter-walk-test), the Timed up and go test (TUG), and maximum walking distance (2-min-walking-test).

Results

Functional gait measures correlated to fear of falling (gait speed: r = −0.726; step length: r = −0.689; TUG: r = 0.721; 2-min: r = −0.709) and the physical component of QoL (gait speed: r = 0.541; step length: r = 0.531; TUG: r = −0.512; 2-min: r = 0.548). Furthermore, FES-I (r = 0.767) and QoL (r = -0.728) correlated with the clinical gold standard (SPRS). Gait measures strongly correlated with SPRS (gait speed: r = −0.787; step length: r = −0.821; TUG: r = 0.756; 2-min: r = −0.791).

Conclusion

Functional gait measures reflect fear of falling, QoL, and mobility in HSP. The metric, semi-quantitative gait measures complement the clinician’s evaluation and support the clinical workup by more objective parameters.

中文翻译：

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功能性步态测量与遗传性痉挛性截瘫患者的跌倒恐惧和生活质量相关：一项横断面研究

客观的

步态障碍是遗传性痉挛性截瘫 (HSP) 的主要运动症状，可能与对跌倒的恐惧增加和生活质量 (QoL) 降低有关。使用痉挛性截瘫评定量表 (SPRS) 对 HSP 中的疾病特定症状进行评定。然而，有限的研究通过将这些标准化评估与患者的自我感知障碍和临床确定的评分进行比较，评估了更客观、易于应用的步态测量。因此，本研究的目的是将功能步态测量与害怕跌倒和生活质量的自评问卷以及作为临床金标准的 SPRS 相关联。

方法

本研究纳入了符合 HSP 临床诊断标准的HSP 患者（“纯”表型，n  = 22）以及年龄和性别匹配的健康受试者（n  = 22）。使用 SPRS 评估运动障碍，国际跌倒疗效量表 (FES-I) 评估跌倒恐惧，SF-12 评估 QoL。功能步态测量包括步态速度和步长（10 米步行测试）、定时起跑测试（TUG）和最大步行距离（2 分钟步行测试）。

结果

与害怕跌倒相关的功能性步态测量（步态速度：r  = -0.726；步长：r  = -0.689；TUG：r  = 0.721；2 分钟：r  = -0.709）和生活质量的物理成分（步态速度：r  = 0.541；步长：r  = 0.531；TUG：r  = -0.512；2 分钟：r  = 0.548）。此外，FES-I ( r  = 0.767) 和 QoL ( r  = -0.728) 与临床金标准 (SPRS) 相关。步态测量与 SPRS 密切相关（步态速度：r  = -0.787；步长：r  = -0.821；TUG：r  = 0.756；2 分钟：r = -0.791)。

结论

功能性步态测量反映了 HSP 中对跌倒、生活质量和活动性的恐惧。度量、半定量步态测量补充了临床医生的评估，并通过更客观的参数支持临床检查。