Izvedljivost Indeksa premičnosti de Morton in povezanost z 2- ter 6-minutnim testom hoje pri pacientih z mišično distrofijo : magistrsko delo

Jerman, Anja (author), Puh, Urška (mentor), Moharić, Metka (co-mentor), Kovačič, Tine (reviewer)

Uvod: Za oceno premičnosti pacientov z mišično distrofijo ne obstaja specifično merilno orodje, zato nas je zanimala izvedljivost Indeksa premičnosti de Morton (DEMMI) in primerjava s 6- (6MWT) ter 2-minutnim testom hoje (2MWT), ki se že uporabljata v klinični praksi pri pacientih z mišično distrofijo. Namen: Preveriti izvedljivost DEMMI, 6MWT in 2MWT ter razločevalno in konvergentno veljavnost le-teh pri preiskovancih s facioskapulohumeralno (FSHD) in ramensko-medenično distrofijo (RMD). Metode dela: Sodelovalo je 21 preiskovancev z RMD in 21 preiskovancev s FSHD, starih od 31 do 80 let. Pridobljeni so bili podatki o sposobnosti za hojo (razvrstitev funkcijske premičnosti - FAC v 6 kategorij). Preiskovanci so bili najprej ocenjeni z DEMMI. Z 2MWT in 6MWT so nadaljevali preiskovanci z oceno FAC 3-6. Za ugotavljanje razlik med preiskovanci obeh podskupin pri izidu DEMMI smo uporabili Mann-Whitneyev U test, pri izidu 2MWT in 6MWT pa t-test za neodvisne vzorce. Povezanost med merilnimi orodji smo ugotavljali z Pearsonovim koeficientom korelacije. Učinek tal in stropa smo ugotavljali z deležem preiskovancev z najnižjim in najvišjim možnim številom doseženih točk oziroma nezmožnosti izvedbe testa hoje. Rezultati: Ugotovljen je bil učinek tal za DEMMI pri preiskovancih z RMD. Pri preiskovancih obeh podskupin je bil ugotovljen učinek tal za oba testa hoje. Ugotovljena je bila statistično značilna razlika v izidih DEMMI med preiskovanci obeh podskupin. V povprečju so preiskovanci s FSHD dosegali več točk. Med preiskovanci obeh podskupin nismo zabeležili statistično značilnih razlik v izidih 2MWT in 6MWT. Konvergentna veljavnost DEMMI s testoma hoje je bila visoka do zelo visoka. Pri preiskovancih z RMD nismo ugotovili statistično značilne povezanosti med izidi DEMMI in testoma hoje. Pri vseh preiskovancih skupaj in za vsako podskupino posebej smo ugotovili statistično značilno odlično pozitivno povezanost med izidi 2MWT in 6MWT. Zaključek: Uporaba DEMMI v klinični praksi bi bila smiselna pri pacientih s FSHD in RMD, dokler so sposobni premikanja po postelji. 2MWT je primeren za paciente s slabšo sposobnostjo hoje, večjo utrudljivostjo in slabšim ravnotežjem. Zaradi odlične korelacije s 6MWT se ga lahko uporabi tudi pri tistih pacientih z dobro sposobnostjo hoje.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, mišična distrofija, DEMMI, 6-minutni test hoje, 2-minutni test hoje, merske lastnosti
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Jerman]
• Year: 2023
• Number of pages: 38 str., [6] str. pril.
• PID: 20.500.12556/RUL-144633
• UDC: 615.8
• COBISS.SI-ID: 144245507
• Publication date in RUL: 04.03.2023

Secondary language

• Language: English
• Title: Feasibility of de Morton mobility index and its correlations with two- and six-minutes walk tests in patients with muscular dystrophy : master thesis

Abstract

Introduction: Since there is no specific measurement tool to assess mobility in patients with muscular dystrophy, we were interested in the feasibility of the de Morton Mobility Index (DEMMI) and in comparing the 6-minute walk test (6MWT) and the 2-minute walk test (2MWT), which are already used in clinical practise in patients with muscular dystrophy. Purpose: To test the feasibility of the DEMMI, the 6MWT, the 2MWT and their discriminant and convergent validity in patients with facioscapulohumeral muscular dystrophy (FSHD) and limb girdle muscular dystrophy (LMGD). Methods: Twenty-one subjects with LGMD and twenty-one subjects with FSHD, all aged between 31 and 80 years, were included in the study. First, data on their walking abilities were collected (functional ambulation classification - FAC in 6 categories). The subjects were first assessed with the DEMMI. Only subjects who achieved a FAC score between 3-6 could proceed to the 2MWT and the 6MWT. The Mann-Whitney U test was used to detect differences between subjects in the two subgroups for the DEMMI score, while the independent samples t-test was used for the 2MWT and 6MWT scores. The correlation between the measurement instruments was determined using the Pearson correlation coefficient. The floor-ceiling effect was determined by the proportion of subjects with the lowest and highest possible score or inability to perform the walk test. Results: The floor effect was observed for DEMMI in subjects with LMGD. In addition, the floor effect was also observed for both walk tests in subjects of both subgroups. There was a statistically significant difference in DEMMI scores between subjects in the two subgroups. On average, subjects with FSHD scored higher. There were no statistically significant differences in 2MWT and 6MWT scores between the two subgroups. The convergent validity of the DEMMI with the two walking tests was high to very high. For subjects with LMGD, we found no statistically significant correlations between the results of the DEMMI and the results of the two walk tests (2MWT and 6MWT). For all subjects together and for each subgroup separately, we found a statistically significant and excellent positive correlation between the 2MWT and 6MWT results. Conclusion: In clinical practise, the use of DEMMI would be useful and practical for patients with FSHD and LMGD until they are able to move around the bed. The 2MWT is appropriate for patients with lower ambulation, increased fatigue and poorer balance. Due to its excellent correlation with the 6MWT, it can also be used for patients with good walking ability.

• Keywords: master's theses, physiotherapy, muscular dystrophy, DEMMI, 6-minute walk test, 2-minute walk test, measurement properties