背景:多发性硬化症(MS)患者遇到的最令人衰弱的问题之一是失去平衡和协调。我们的研究旨在综合评价1年的太极拳运动对MS患者的主观和客观的方法,包括姿势描记术.
方法:这是一项从2019年1月1日至2020年1月1日进行的为期一年的单组纵向研究。感兴趣的主要结果是Mini-Balance评估系统测试(Mini-BESTest)和静态姿势测量,作为检测与姿势控制/平衡损害相关的细微变化的客观方法。次要结果是抑郁的测量,焦虑,认知表现,和生活质量。所有客观和主观参数都进行了四次评估:在基线,过了三点,6个月和12个月的常规太极训练。将差异计算为每次测量的每个时间点值减去基线值。如果正常测试通过,采用参数单样本t检验,如果失败,使用Wilcoxon符号秩检验来测试基线和每个时间点之间的差异。使用Bonferroni校正进行多重比较,将α设定为0.017。
结果:在25名MS患者中,在完成12个月的程序后,纳入了15名MS女性(平均年龄44.27岁)进行统计分析。12个月后,在所有客观平衡和步态测试中都发现了显着改善:Mini-BESTest(p<0.001),静态姿势测量(足底压力中心的总面积-TA;p=0.015),25英尺步行测试(25FWT;p=0.001),焦虑(贝克焦虑量表-BAI;p=0.005)和认知测试(起搏听觉系列加法测试-PASAT;p=0.003)。抑郁的衡量标准(贝克抑郁量表-BDI;p=0.071),认知(符号数字模式测试-SDMT;p=0.079),与健康相关的生活质量(欧洲生活质量5维问卷-EQ-5D-5L;p=0.095)显示出改善趋势,但不显著,这可能是小样本和由于II型误差而增加的偏差的结果。
结论:根据这些初步结果,这项研究表明长期太极拳训练对MS患者可能的有益作用。尽管这些发现需要通过对两种性别参与者的更大样本进行进一步研究来证实,并且需要更严格的随机对照试验(RCT)设计,我们的发现支持MS患者定期和长期太极拳运动的建议。
结果:
■NCT05474209。
BACKGROUND: One of the most debilitating problems encountered by people with multiple sclerosis (MS) is the loss of balance and coordination. Our
study aimed to comprehensively evaluate the effectiveness of one year of Tai-chi exercise in patients with MS using both subjective and objective methods, including posturography.
METHODS: This was a single-group longitudinal one-year
study performed from the 1st of January 2019 to the 1st of January 2020. The primary outcomes of interest were the Mini-Balance Evaluation Systems Test (Mini-BESTest) and static posturography measures as objective methods to detect subtle changes associated with postural control/balance impairment. Secondary outcomes were measures of depression, anxiety, cognitive performance, and quality of life. All objective and subjective parameters were assessed four times: at baseline, and after three, six and 12 months of regular Tai-chi training. The difference was calculated as a subtraction of baseline values from every timepoint value for each measurement. If the normality test was passed, parametric one-sample t-test was used, if failed, Wilcoxon signed ranks test was used to test the difference between the baseline and each timepoint. Alpha was set to 0.017 using Bonferroni correction for multiple comparisons.
RESULTS: Out of 25 patients with MS enrolled, 15 women with MS (mean age 44.27 years) were included for statistical analyses after completing the 12-month program. After 12 months, significant improvements were found in all objective balance and gait tests: Mini-BESTest (p<0.001), static posturography measures (total area of the centre of foot pressure - TA; p = 0.015), 25 Feet Walk Test (25FWT; p = 0.001), anxiety (Beck Anxiety Inventory - BAI; p = 0.005) and cognition tests (Paced Auditory Serial Addition Test - PASAT; p = 0.003). Measures of depression (Beck Depression Inventory - BDI; p = 0.071), cognition (Symbol Digit Modalities Test - SDMT; p = 0.079), and health-related quality of life (European Quality of Life 5-Dimensions Questionnaire - EQ-5D-5L; p = 0.095) showed a trend of improvement but were not significant, which could be the result of a small sample and increased bias due the type II error.
CONCLUSIONS: According to these preliminary results, this
study indicates the possible beneficial effects of long-term Tai-chi training on patients with MS. Although these findings need to be confirmed by further studies with a larger sample of participants of both genders and require more rigorous randomized controlled trials (RCT) design, our findings support the recommendation of regular and long-term Tai-chi exercise in patients with MS.
RESULTS: UNASSIGNED: NCT05474209.