Posturography does not test vestibulospinal function
Posturography does not test vestibulospinal function
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DOI：
10.1016/s0194-5998(99)70401-8
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发表时间：
1999-02-01
影响因子：
3.4
通讯作者：
Krebs, DE
中科院分区：
文献类型：
--
作者：
Evans, MK;Krebs, DE
姿势描记术的临床用途尚不清楚，尽管在美国的一些地区，包括波士顿，每次测试的费用超过500美元。我们对29例稳定的慢性前庭功能减退患者进行了横断面和前瞻性的盲法前庭眼和前庭脊髓试验; 22例患者双侧受累（BVH），7例单侧受累（UVH）。前庭眼功能通过眼震电图热刺激和0.05 Hz正弦垂直轴旋转增益进行评估。前庭脊髓功能通过移动平台和视觉环绕姿势图感觉组织测试（SOTs），步态实验室中的起搏和自由步态以及定时步态和站立的临床测试进行评估。姿势描记术SOT移动平台测试4至6，旨在评估前庭功能，相关性显着（r小于或等于0.72，P大于或等于0.01）与前庭眼测试中的5个比较BVH患者。然而，姿势图SOT结果与其他前庭脊髓测量结果相关性较差：在18项临床平衡和步态功能比较中，只有7项具有统计学意义（r小于或等于0.69，P大于或等于0.01），步态实验室动态稳定性测量的12次比较中有2次比较BVH组与正常对照组比较差异有统计学意义（r ≤ 0.55，P> 0.01）。然而，当平台和视觉环境都移动时（SOT 6），与静态站立临床测量（r = 0.51至0.69，P < 0.01）和起搏步态期间全身最大力臂（r = 0.55，P < 0.01）的相关性具有统计学意义。UVH患者的姿势图评分与任何前庭眼或其他前庭脊髓测量值无显著相关性。这些数据表明，在BVH患者中，姿势描记术SOT评分与公认的前庭-眼功能指标最多适度相关，与平衡控制的临床指标相关性较差，与动态步态表现指标相关性较差。我们的结论是姿势图SOT不能评估前庭脊髓功能。
The clinical usefulness of posturography is unknown, despite its costing more than $500 per test in some areas of the United States, including Boston. We cross-sectionally and prospectively studied blinded vestibule-ocular and vestibulospinal tests from 29 stable patients with chronic vestibular hypofunction; 22 patients were affected bilaterally (BVH), and 7 were affected unilaterally (UVH). Vestibuloocular function was assessed by electronystagmographic caloric stimulation and sinusoidal vertical axis rotation gains at 0.05 Hz. Vestibulospinal function was assessed by moving-platform and visual-surround posturography sensory organization tests (SOTs), paced and free gait in a gait laboratory, and clinical tests of timed gait and standing. Posturography SOT moving-platform tests 4 through 6, designed to assess vestibular function, correlated significantly (r less than or equal to 0.72, P greater than or equal to 0.01) with vestibule-ocular tests in 5 of 6 comparisons among BVH patients. Posturography SOT results, however, correlated poorly with other vestibulospinal measures: correlations were statistically significant for only 7 of 18 comparisons with clinical balance and gait function (r less than or equal to 0.69, P greater than or equal to 0.01) and with 2 of 12 comparisons for gait laboratory dynamic stability measures (r less than or equal to 0.55, P greater than or equal to 0.01) among the BVH patients. When both the platform and visual surround moved (SOT 6), however, correlations were statistically significant with static standing clinical measures (r = 0.51 to 0.69, P < 0.01) and with whole-body maximum moment arm during paced gait (r = 0.55, P < 0.01). Posturography scores for the UVH patients did not significantly correlate with any vestibule-ocular or other vestibulospinal measures. These data indicate that among patients with BVH posturography SOT scores relate at best modestly with accepted measures of vestibule-ocular function, less well with clinical measures of balance control, and poorly with dynamic gait-performance measures. We conclude that posturography SOT does not assess vestibulospinal function.