Trunk sway measures of postural stability during clinical balance tests: effects of a unilateral vestibular deficit
Trunk sway measures of postural stability during clinical balance tests: effects of a unilateral vestibular deficit
复制标题
DOI：
10.1016/s0966-6362(01)00132-1
复制
发表时间：
2001-12-01
期刊：
影响因子：
2.4
通讯作者：
Pierchala, K
中科院分区：
文献类型：
--
作者：
Allum, JHJ;Adkin, AL;Pierchala, K
本研究评估了在临床平衡任务中躯干摇摆的量化测量是否足够敏感以识别平衡障碍，并且可能足够特异以区分不同类型的平衡障碍。我们使用了一个重量轻，易于连接，身体佩戴的设备来测量躯干角速度在滚动和俯仰平面在一些立场和步态任务类似的Tinetti和CTSIB协议。这些任务包括用一条或两条腿站立，双眼睁开或闭合在泡沫或坚固的支撑表面上，走八个串联步骤，走五个步骤，同时水平旋转或俯仰头部，走过低障碍物，上下楼梯。通过比较15例明确定义的急性平衡缺陷（突然单侧前庭丧失（UVL））患者与26例手术前小脑桥脑角肿瘤（CPAT）引起的不太严重的慢性平衡问题患者的测试结果，以及88例年龄和性别匹配的健康受试者的测试结果，寻求任务，量化时可能提供平衡病理学的最佳筛选。UVL患者表现出显着大于正常的躯干摇摆的所有双腿站立任务，特别是那些闭上眼睛泡沫支撑表面上进行。在旋转或俯仰头部时行走，以及在泡沫支撑表面上行走八个串联步骤时，摇摆也更大。有趣的是，患者可以完成步态任务，例如几乎正常地在障碍物上行走，但需要更长的时间。CPAT患者的躯干摇摆值介于UVL患者和正常人之间。躯干摇摆幅度测量的组合（滚动角和俯仰速度），从在泡沫支撑件上闭眼站立的双腿站立任务、在正常支撑件表面上睁眼站立任务，以及从在旋转或俯仰头部的同时行走五步的步态任务，并且在泡沫上走8个串联步骤允许对正常受试者的97%的正确识别和对急性前庭丧失患者的93%的正确识别。超过50%的CPAT患者可被归类为中度平衡缺陷组，其余被归类为正常组。我们的研究结果表明，在五个简单的临床平衡测试，其中四个探头的立场和步态控制在更困难的感觉条件下，测量躯干摇摆的形式滚动角和俯仰角速度，可以可靠地和定量区分患者与健康对照组有明确的平衡赤字。此外，如果要尝试诸如初步诊断而不是筛查之类的功能，则可能需要改进这些躯干摇摆测量技术。(C)2001 Elsevier Science B.V.保留所有权利。
This research evaluated whether quantified measures of trunk sway during clinical balance tasks are sensitive enough to identify a balance disorder and possibly specific enough to distinguish between different types of balance disorder. We used a light-weight, easy to attach, body-worn apparatus to measure trunk angular velocities in the roll and pitch planes during a number of stance and gait tasks similar to those of the Tinetti and CTSIB protocols. The tasks included standing on one or two legs both eyes-open and closed on a foam or firm support-surface, walking eight tandem steps, walking five steps while horizontally rotating or pitching the head, walking over low barriers, and up and down stairs. Tasks were sought, which when quantified might provide optimal screening for a balance pathology by comparing the test results of 15 patients with a well defined acute balance deficit (sudden unilateral vestibular loss (UVL)) with those of 26 patients with less severe chronic balance problems caused by a cerebellar-pontine-angle-tumour (CPAT) prior to surgery, and with those of 88 age- and sex-matched healthy subjects. The UVL patients demonstrated significantly greater than normal trunk sway for all two-legged stance tasks especially those performed with eyes closed on a foam support surface. Sway was also greater for walking while rotating or pitching the head, and for walking eight tandem steps on a foam support surface. Interestingly, the patients could perform gait tasks such Lis walking over barriers almost normally, however took longer. CPAT patients had trunk sway values intermediate between those of UVL patients and normals. A combination of trunk sway amplitude measurements (roll angle and pitch velocity) from the stance tasks of standing on two legs eyes closed on a foam support, standing eyes open on a normal Support surface, as well as from the gait tasks of walking five steps while rotating, or pitching the head, and walking eight tandem steps on foam permitted a 97% correct recognition of a normal subject and a 93% correct recognition of an acute vestibular loss patient. Just over 50% of CPAT patients could be classified into a group with intermediate balance deficits, the rest were classified as normal. Our results indicate that measuring trunk sway in the form of roll angle and pitch angular velocity during five simple clinical tests of equilibrium, four of which probe both stance and gait control under more difficult sensory conditions, can reliably and quantitatively distinguish patients with a well defined balance deficit from healthy controls. Further, refinement of these trunk sway measuring techniques may be required if functions such as preliminary diagnosis rather than screening are to be attempted. (C) 2001 Elsevier Science B.V. All rights reserved.