Abstract:
Mobility limitations, including a decrease in walking speed, are major issues for people with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). Improving our understanding of factors influencing walking speed in ARSACS may inform the development of future interventions for gait rehabilitation and contribute to better clinical practices. The objective of the study was to identify the factors influencing the self-selected walking speed in adults with ARSACS. The dependent variable of this cross-sectional study was the self-selected speed and the factors (independent variables) were age, sex, balance, balance confidence, knee flexion and extension cocontraction indexes, lower limb coordination, passive range of motion of ankle dorsiflexion, knee and hip extension, and global spasticity. Multiple regression models were used to assess the relationships between walking speed and each factor individually. Six factors were significantly associated with walking speed and thus included in regression models. The models explained between 42.4 and 66.5% of the total variance of the self-selected walking speed. The factors that most influence self-selected walking speed are balance and lower limb coordination. In order of importance, the other factors that also significantly influence self-selected walking speed are ankle dorsiflexion range of motion, lower limb spasticity, knee extension range of motion, and confidence in balance. Balance and lower limb coordination should be targeted in rehabilitation interventions to maintain walking ability and functional independence as long as possible. The six factors identified should also be included in future studies to deepen our understanding of walking speed.
摘要:
移动性限制,包括步行速度的降低,是Charlevoix-Saguenay常染色体隐性遗传性痉挛性共济失调(ARSACS)患者的主要问题。提高我们对影响ARSACS步行速度的因素的理解可能会为未来的步态康复干预措施的发展提供信息,并有助于更好的临床实践。该研究的目的是确定影响ARSACS成人自我选择步行速度的因素。本横断面研究的因变量是自选速度,因素(自变量)是年龄,性别,balance,平衡信心,膝关节屈伸协同收缩指数,下肢协调,踝关节背屈的被动运动范围,膝盖和臀部伸展,和全球痉挛。使用多元回归模型分别评估步行速度与每个因素之间的关系。六个因素与步行速度显着相关,因此包括在回归模型中。模型解释了自选步行速度总方差的42.4%至66.5%。影响自主选择步行速度最大的因素是平衡和下肢协调。按重要性排序,其他显著影响自主选择步行速度的因素是踝关节背屈运动范围,下肢痉挛,膝盖伸展运动范围,对平衡的信心。在康复干预中,应以平衡和下肢协调为目标,以尽可能长时间地保持步行能力和功能独立性。确定的六个因素也应包括在未来的研究中,以加深我们对步行速度的理解。