多发性硬化症患者呼吸肌力量测量的可靠性和最小可检测变化。

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY Journal of Neurologic Physical Therapy Pub Date : 2024-04-01 Epub Date: 2023-11-24 DOI:10.1097/NPT.0000000000000462

Sandra Aguilar-Zafra, Raúl Fabero-Garrido, Tamara Del Corral, Ibai López-de-Uralde-Villanueva

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引用次数: 0

摘要

背景和目的:在多发性硬化症(MS)患者中，呼吸肌力量测量的重测信度和最小可检测变化(MDCs)尚未确定。本研究确定了该人群中特定呼吸肌力量测量的重测信度和MDCs，以及它们与健康相关生活质量(HRQoL)、残疾、呼吸困难和身体活动水平测量的关联。此外，该研究还检查了不同残疾程度之间呼吸肌力量的差异。方法:61例多发性硬化症患者两次就诊，间隔7 ~ 10天。呼吸肌力量采用最大吸气和呼气压力(MIP/MEP)， HRQoL采用EuroQol-5D-5L(指数和视觉模拟量表[EQ-VAS])，残疾采用扩展残疾状态量表，呼吸困难采用医学研究理事会量表，身体活动水平采用国际身体活动问卷。结果:呼吸肌力量测量具有极好的重测信度(ICC≥0.92)。MIP为15.42 cmH2O, MEP为17.84 cmH2O。呼吸肌力量(MIP/MEP cmH2O和预测值百分比)越高的受试者HRQoL越高(r = 0.54 ~ 0.62, P < 0.01, EQ-5D-5L指数;r = 0.30 ~ 0.42, P < 0.05, EQ-VAS);呼气肌力(cmH2O和预测值百分比)较高的患者残疾水平(r≤-0.66)和呼吸困难水平(r≤-0.61)较低。不同残疾程度间呼吸肌力差异有统计学意义(P < 0.01;D≥0.73)。讨论与结论:呼吸肌力量测量在多发性硬化症患者中提供了极好的重测可靠性，可以解释并应用于临床环境。呼吸肌力量低会导致HRQoL较差;具体来说，呼气肌力量似乎对残疾状态和呼吸困难有最大的影响。视频摘要可获得作者的更多见解(参见视频，补充数字内容1，可在:http://links.lww.com/JNPT/A455)。

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Reliability and Minimal Detectable Change for Respiratory Muscle Strength Measures in Individuals With Multiple Sclerosis.

Background and purpose: The test-retest reliability and minimal detectable changes (MDCs) for respiratory muscle strength measures have not been determined in individuals with multiple sclerosis (MS). This study determined the test-retest reliability and MDCs for specific respiratory muscle strength measures, as well as their associations with health-related quality of life (HRQoL), disability, dyspnea, and physical activity level measures in this population. In addition, the study examined differences in respiratory muscle strength between different degrees of disability.

Methods: Sixty-one individuals with MS attended 2 appointments separated by 7 to 10 days. Respiratory muscle strength was evaluated by maximal inspiratory and expiratory pressures (MIP/MEP), HRQoL by EuroQol-5D-5L (index and visual analog scale [EQ-VAS]), disability by the Expanded Disability Status Scale, dyspnea by the Medical Research Council scale, and physical activity levels by the International Physical Activity Questionnaire.

Results: Respiratory muscle strength measures had excellent test-retest reliability (ICC ≥ 0.92). The MDC for MIP is 15.42 cmH 2 O and for MEP is 17.84 cmH 2 O. Participants with higher respiratory muscle strength (MIP/MEP cmH 2 O and percentage of predicted values) had higher HRQoL ( r = 0.54-0.62, P < 0.01, EQ-5D-5L index; r = 0.30-0.42, P < 0.05, EQ-VAS); those with higher expiratory muscle strength (cmH 2 O and percentage of predicted values) had lower levels of disability ( r ≤ -0.66) and dyspnea ( r ≤ -0.61). There were differences in respiratory muscle strength between different degrees of disability ( P < 0.01; d ≥ 0.73).

Discussion and conclusion: Respiratory muscle strength measures provide excellent test-retest reliability in individuals with MS. MDCs can be interpreted and applied in the clinical setting. Low respiratory muscle strength can contribute to a poor HRQoL; specifically, expiratory muscle strength appears to have the strongest influence on disability status and dyspnea.

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来源期刊

Journal of Neurologic Physical Therapy CLINICAL NEUROLOGY-REHABILITATION

CiteScore

5.70

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Neurologic Physical Therapy (JNPT) is an indexed resource for dissemination of research-based evidence related to neurologic physical therapy intervention. High standards of quality are maintained through a rigorous, double-blinded, peer-review process and adherence to standards recommended by the International Committee of Medical Journal Editors. With an international editorial board made up of preeminent researchers and clinicians, JNPT publishes articles of global relevance for examination, evaluation, prognosis, intervention, and outcomes for individuals with movement deficits due to neurologic conditions. Through systematic reviews, research articles, case studies, and clinical perspectives, JNPT promotes the integration of evidence into theory, education, research, and practice of neurologic physical therapy, spanning the continuum from pathophysiology to societal participation.