日本の地方公共団体における行政刊行物の管理に関する研究

筑波大学 (University of Tsukuba)201

Evidence for the different physiological significance of the 6- and 2-minute walk tests in multiple sclerosis

<p>Abstract</p> <p>Background</p> <p>Researchers have recently advocated for the 2-minute walk (2MW) as an alternative for the 6-minute walk (6MW) to assess long distance ambulation in persons with multiple sclerosis (MS). This recommendation has not been based on physiological considerations such as the rate of oxygen consumption (V·O₂) over the 6MW range.</p> <p>Objective</p> <p>This study examined the pattern of change in V·O₂over the range of the 6MW in a large sample of persons with MS who varied as a function of disability status.</p> <p>Method</p> <p>Ninety-five persons with clinically-definite MS underwent a neurological examination for generating an Expanded Disability Status Scale (EDSS) score, and then completion of the 6MW protocol while wearing a portable metabolic unit and an accelerometer.</p> <p>Results</p> <p>There was a time main effect on V·O₂during the 6MW (<it>p </it>= .0001) such that V·O₂increased significantly every 30 seconds over the first 3 minutes of the 6MW, and then remained stable over the second 3 minutes of the 6MW. This occurred despite no change in cadence across the 6MW (<it>p </it>= .84).</p> <p>Conclusions</p> <p>The pattern of change in V·O₂indicates that there are different metabolic systems providing energy for ambulation during the 6MW in MS subjects and steady state aerobic metabolism is reached during the last 3 minutes of the 6MW. By extension, the first 3 minutes would represent a test of mixed aerobic and anaerobic work, whereas the second 3 minutes would represent a test of aerobic work during walking.</p

Mobility, Balance and Falls in Persons with Multiple Sclerosis

BACKGROUND: There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS). METHODS: 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery. RESULTS: Over 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS. CONCLUSIONS: The current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established

Social cognitive theory-based physical activity intervention delivered by non-supervised technology in persons with multiple sclerosis

Physical inactivity has been considered an issue in persons with multiple sclerosis (MS) despite the well-documented evidence supporting benefits of physical activity (Debolt & McCubbin, 2004; Motl, McAuley, & Snook, 2005; Ng & Kent-Braun, 1997; Plow, Mathiowetz, & Lowe, 2009; White & Dressendorfer, 2004). This highlights the importance of developing behavioral interventions for increasing physical activity among persons with MS. The primary purpose of the current study was to examine the efficacy of a 6-week, theory-based intervention (i.e., social cognitive theory [SCT]) delivered by newsletters and telephone calls for increasing physical activity in persons with MS who were physically inactive and had middle levels of self-efficacy. The intervention group received SCT-based newsletters and phone calls whereas the control group received newsletters that did not include any physical activity information (i.e., stress management, nutrition, and allergies) over the 6 weeks. Pedometer and log book were provided to the intervention group for the purpose of self-monitoring physical activity. Phone calls were delivered to both groups, but there was no discussion about physical activity for the control group. The results of this study indicated that the intervention group who received SCT-based intervention materials appeared to be more physically active based on self-reported physical activity (d = 0.56, p = .02) over the 6 weeks compared with the control group that received materials including non-physical activity (d = -0.13, p = .45). Additionally, only goal setting was changed by the intervention (d = 0.68, p ≤ .01) and identified as a significant mediator of change in self-reported physical activity (ß = 0.35, p = .007). Overall, the current study provides initial evidence for the potential benefit of theory-based interventions delivered by newsletters and phone calls for promoting self-reported physical activity in persons with MS who are inactive and have middle levels of self-efficacy

Evidence for the different physiological significance of the 6- and 2-minute walk tests in multiple sclerosis

Background: Researchers have recently advocated for the 2-minute walk (2MW) as an alternative for the 6-minute walk (6MW) to assess long distance ambulation in persons with multiple sclerosis (MS). This recommendation has not been based on physiological considerations such as the rate of oxygen consumption (V·O2) over the 6MW range. Objective: This study examined the pattern of change in V·O2 over the range of the 6MW in a large sample of persons with MS who varied as a function of disability status. Method: Ninety-five persons with clinically-definite MS underwent a neurological examination for generating an Expanded Disability Status Scale (EDSS) score, and then completion of the 6MW protocol while wearing a portable metabolic unit and an accelerometer. Results: There was a time main effect on V·O2 during the 6MW (p = .0001) such that V·O2 increased significantly every 30 seconds over the first 3 minutes of the 6MW, and then remained stable over the second 3 minutes of the 6MW. This occurred despite no change in cadence across the 6MW (p = .84). Conclusions: The pattern of change in V·O2 indicates that there are different metabolic systems providing energy for ambulation during the 6MW in MS subjects and steady state aerobic metabolism is reached during the last 3 minutes of the 6MW. By extension, the first 3 minutes would represent a test of mixed aerobic and anaerobic work, whereas the second 3 minutes would represent a test of aerobic work during walking