杜氏肌营养不良儿童的运动功能与全身力量、年龄的相关性研究

目的 探讨杜氏肌营养不良(DMD)儿童的运动功能与全身肌肉力量及年龄的相关性,为更好地进行该病管理提供理论依据。方法 对2017年1月-2021年3月在深圳市儿童医院就诊且符合纳入标准的DMD患儿进行运动功能测试(MFM-32)、计时测试(仰卧站起测试、上4级阶梯测试、10 m走/跑测试)、Vignos评分、Brooke评分及全身的徒手肌力测试。采用Spearman相关性检验分析MFM各项分值与其他指标之间相关性,同时分析全身运动功能及肌力与年龄之间的关系。结果 共140名4~12岁DMD儿童患者被纳入研究,平均年龄(8.0±1.87)岁,MFM-32总分及D1区分值与下肢肌肉力量、计时测试、Vignos评分呈强-极强相关(r=-0.887~0.677,P<0.05);D2区分值与计时测试中等相关(r=-0.478~-0.423,P<0.05)),D3区的分值与其他指标不相关(P>0.05)。年龄与MFM-32总分及D1区分值、全身肌肉力量呈中等相关(r=-0.585~-0.468,P<0.05)),年龄与MFM-32 D2区分值不相关(P>0.05),与D3区呈弱相关(r=0.317,P<0.05)。结论 MFM-32的各项分值与全身肌肉力量、计时测试、Vignos评分及Brooke评分具有不同程度的相关性,可反映DMD患者的运动功能。儿童时期的DMD患者的下肢运动功能下降较明显,应首要加强其下肢运动功能及肌肉力量。

Correlation of motor function with muscle strength and age in children with Duchenne muscular dystrophy

Objective To investigate the correlation of motor function with muscle strength and age in children with Duchenne muscular dystrophy (DMD), so as to provide theoretical reference for better management of DMD. Methods DMD Children in Shenzhen Children's Hospital from January 2017 to March 2021 were enrolled in this study, and were assessed by Motor Function Measure (MFM-32), timing tests (supine standing test, upper 4-step step test, 10 meter walk/run test), Vignos score, Brooke score and Manual Muscle Testing.Spearman correlation test was used to analyze the relationship between scores of MFM-32 and other indexes.Besides, the association of age with motor function and muscle strength was analyzed. Results A total of 140 DMD children aged 4 to 12 years were enrolled in this study, with an average age of (8.0±1.87) years old.The total score and D1 subscale of the MFM-32 were strongly correlated with muscle strength, timing test and Vignos score (r=-0.887 - 0.677,P<0.05).The score of D2 subscale was moderately correlated with timing test (r=-0.478 - -0.423,P<0.05), while the score of D3 subscale was not correlated with these measures (P＞0.05).Children's age was moderately associated with MFM-32 score, score of D1 subscale and the whole body muscle strength (r=-0.585 - -0.468,P<0.05).However, it appeared to be not correlated with the score of D2 subscale (P＞0.05), and was slightly correlated with the score of D3 subscale (r =0.317, P<0.05). Conclusions The scores of MFM-32 correlate with whole body muscle strength, timing test, Vignos score and Brooke score to different degrees, which can reflect the motor function of DMD children.The lower limb motor function of DMD children during childhood decreases significantly, and should be given priority to strengthen their lower extremity motor function and muscle strength.