Multipl Skleroz Hastalarında Yürüme Mesafesi için Prediktif Modelin Oluşturulması

Abstract

KARA, İ., Creating a Predictive Model for Walking Distance in Multipl Sclerosis Patients, Hacettepe University, Graduate School of Health Sciences, Neurology Physiotherapist Program, Master Thesis, Ankara, 2024. Our study was carried out of to create a predictive mathematical model to be used in estimating walking distance in Multiple Sclerosis patients. A total of 72 individuals with MS, 50 women and 22 men, who were over the age of 18 (38,31±11,61) and had an Expanded Disability Status Scale (EDSS) score between 1-5,5 participated in our study. The patients included in the study were first asked how far they could walk without resting without getting tired and their subjective walking distances were recorded. Then the patients were walked until they got tired and their maximum walking distance was recorded. Within one week after recording the walking distance, 6 Minute Walk Test (6MWT) and 25 Step Walk Test (25FWT) were used for walking, muscle strength and muscle endurance tests for lower extremity and trunk muscles, Community Balance Mobility Scale (CB&MS) for balance evaluation and " "One Leg Standing Test", Fatigue Severity Scale (FSS) were used for general fatigue level, and Modified Borg Scale was used for fatigue before and after 6MWT. Additionally, walking and ambulation indices were determined using 6MWT and 25FWT. In our study, Pearson Correlation Analysis was used to examine the relationship between maximum walking distance, strength and endurance of trunk muscles and lower extremity muscles, CB&MS and FSS. As a result of the analysis, the maximum walking distance and knee extension endurance (r=0,743; p=0,001), CB&MS (r=0,730; p=0,001), foot dorsi flexion endurance (r=0,716; p=0,001), knee flexion endurance (r=0,790; p=0,001) strong positive and significant relationship was found between. At the same time a moderately negative (r=-0,644; p<0,001) and significant result was found between maximum walking distance and FSS. As a result of the multiple regression analysis we conducted with the data we obtanied a model was created that predicts the walking distance by %74,1. This model includes CB&MS, FSS, knee extansion muscle endurance and foot plantar flexor muscle strenght. With the mathematical model we obtained, it has been shown that the actual walking distances of patients can be predicted with a few clinical tests. Keywords: Multiple Sclerosis, Gait, Endurance, Balance, Muscle Strenght, Fatigue