Evaluation of balance in neurologic and geriatric disorders
Evaluation of balance in neurologic and geriatric disorders
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DOI：
10.1016/j.annrmp.2005.04.009
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发表时间：
2005-07-01
期刊：
影响因子：
--
通讯作者：
Casillas, J. M.
中科院分区：
文献类型：
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作者：
Perennou, D.;Decavel, P.;Casillas, J. M.
Objective. - 目的分析平衡功能障碍的主要评估技术和指标的临床应用价值和可操作性。- 超过4000个摘要引用MEDLINE和处理姿势控制和姿势障碍（广泛筛选）进行了审查，以确定在临床背景下使用的主要姿势技术和指数。我们保留了引用频率高的摘要和那些有有趣发现的摘要。相应的关键词被确定为一个特定的搜索的文章，我们分析。- 姿势评估工具可分为顺序项目量表、基于度量或计时测量的测试、姿势图和垂直度感知。这些技术是互补的，在临床上建议将它们结合起来。关于通用工具，如果进行比较分析和修改，将加强与跌倒相关的功效量表（FES）和特定活动平衡信心量表（ABC量表），以便对跌倒恐惧进行可行和可靠的评估。尽管贝格平衡量表（BBS）和功能性前伸测试（FRT）在世界范围内的许多姿势领域中广泛传播，但它们在20世纪90年代没有保持黄金标准所需的标准。静态姿势图应该被正常化，并产生更可靠的指标。视觉，触觉和姿势垂直的主观评估的临床相关性是值得怀疑的，特别是解释姿势残疾。关于特定的工具，Tinetti测试（TT）和时间起走测试（TUG）是最适合于评估非常老年人的姿势能力，其中福尔斯姿势评估的预测有效性仍然是适度的。在中风患者中，中风姿势评估量表（PASS）、姿势描记术、侧移评估和垂直感知是有趣的补充技术。姿势评估主要依赖于帕金森病患者的统一帕金森病评定量表（UMRS）的5个姿势项目，以及小脑或本体感受性共济失调患者的Romberg试验和姿势描记术。一些新的姿势量表多发性硬化症或脊髓损伤患者也正在出现。- 在众多有助于姿势障碍评估的工具中，只有最近的工具（在过去10年中开发的）经过了完整的验证。现在至关重要的是要比较这些工具，不仅在可重复性和内部一致性方面，而且在可行性，响应性和预测有效性方面也是如此。对于一个特定的人口。(C)2005年，Elsevier SAS。图斯所有权保留。
Objective. - To analyse the clinical usefulness and metrological properties of the main techniques and indices used to assess balance disorders.Methods. - More than 4000 abstracts referenced in MEDLINE and dealing with postural control and postural disorders (wide screening) were reviewed to determine the main postural techniques and indices used in a clinical context. We retained abstracts with a high citation frequency and those with interesting findings. Corresponding key words were identified for a specific search of articles that we analysed.Results. - Postural assessment tools can be classified as scales of ordinal items, tests based on metric or chronometric measurement, posturography, and verticality perception. These techniques are complementary, and their association is recommended in a clinical context. Regarding generic tools, the Falls-related Efficacy Scale (FES) and the Activities-specific Balance Confidence scale (ABC scale) would be enhanced if comparatively analysed and reworked to allow for a feasible and reliable assessment of the fear of falling. Despite a wide diffusion in numerous postural fields worldwide, the Berg Balance Scale (BBS) and the Functional Reach Test (FRT) do not have the required criteria to remain the gold standards they were in the 1990 s. Static posturography should be normalised and yield more reliable indices. The clinical relevance of the subjective assessement of visual, haptic, and postural verticals are questionable, especially to explain postural disability. Regarding specific tools, the Tinetti test (TT) and the Time Up and Go test (TUG) are the most suited to assess postural capacities in very elderly people,- in whom the predictive validity of the postural assessment of falls is still modest. In stroke patients, the Postural Assessment Scale for Stroke (PASS), posturography, lateropulsion assessment, and vertically perception are interesting and complementary techniques. Postural assessment relies mainly upon the 5 postural items of the Unified Parkinson Disease Rating Scale (UPDRS) in people with Parkinson disease and upon the Romberg test and posturography in patients with cerebellar or proprioceptive ataxia. Some novel postural scales for patients with multiple sclerosis or spinal cord injury are also emerging.Conclusion. - Among numerous tools that contribute to the assessment of postural disorders, only the most recent ones (developed in the last 10 years) have undergone complete validation. It is now crucial to compare these tools, not only in terms of reproducibility and internal consistency, but also overall, in terms of feasibility, responsiveness, and predictive validity. for a given population. (C) 2005 Elsevier SAS. Tous droits reserves.