Detection of postural sway abnormalities by wireless inertial sensors in minimally disabled patients with multiple sclerosis: a case-control study.
Detection of postural sway abnormalities by wireless inertial sensors in minimally disabled patients with multiple sclerosis: a case-control study.
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在最小残疾患者中，无线惯性传感器对姿势摇摆异常的检测：一项病例对照研究。
DOI：
10.1186/s12984-015-0066-9
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发表时间：
2015-09-01
影响因子：
5.1
通讯作者：
Henry SM
中科院分区：
文献类型：
--
作者：
Solomon AJ;Jacobs JV;Lomond KV;Henry SM
常见的临床神经系统检查可能对多发性硬化症（MS）早期的平衡和活动障碍不敏感，并且可能与患者报告不一致。利用惯性运动传感器的站立姿势摇摆的仪器化测量可以提供平衡障碍的灵敏测量，并且更好地与患者报告相对应。在佩戴无线惯性传感器时，20名MS -扩展残疾状态量表小于3.0且定时25英尺步行小于或等于5秒的受试者以及20名年龄和性别匹配的对照受试者站在泡沫表面上，睁着眼睛和闭着眼睛。46个结果措施的姿势摇摆。逐步逻辑回归模型确定哪些措施的仪器摇摆提供独立的预测群体地位。MS受试者还完成了活动特定平衡信心（ABC）量表和12项MS步行量表（MSWS-12），作为受试者报告的平衡和移动障碍的指标。回归模型确定了中-外侧摇摆路径长度和摇摆加速度幅度的中-外侧范围，每个都是在睁眼条件下，作为区分MS受试者和非MS受试者的仅有的两个重要独立预测因素（模型卡方= 34.55，p < 0.0001）：准确度= 87.5%，阳性似然比= 6（2.09-17.21），阴性似然比= 0.12（0.03-0.44）。摇摆加速度幅度范围与ABC（斯皮尔曼r =-0.567，p = 0.009）和MSWS-12评分（斯皮尔曼r =-0.590，p = 0.006）显著相关。使用无线惯性传感器检测轻度残疾的MS受试者的姿势摇摆异常，这可能意味着在出现临床明显残疾或步态速度受损之前识别平衡障碍的上级灵敏度。需要进一步的研究来证实这些客观鉴定的平衡障碍的临床意义和预测价值。
Common clinical neurological exams can be insensitive to balance and mobility impairment at the early stages of multiple sclerosis (MS) and may not correspond with patient reports. Instrumented measurement of standing postural sway with inertial motion sensors may provide sensitive measures of balance impairment and better correspond with patient reports. While wearing wireless inertial sensors, 20 subjects with MS – Expanded Disability Status Scale of less than 3.0 and a Timed 25 Foot Walk of 5 sec or less – and 20 age- and sex-matched control subjects stood with eyes open and eyes closed on a foam surface. Forty-six outcome measures of postural sway were derived. A stepwise logistic regression model determined which measures of instrumented sway provide independent predictors of group status. Subjects with MS also completed the Activities-Specific Balance Confidence (ABC) scale and the 12-Item MS Walking Scale (MSWS-12) as measures of subject-reported balance and mobility impairment. The regression model identified medio-lateral sway path length and medio-lateral range of sway acceleration amplitude, each in the eyes-open condition, as the only two significant independent predictors to differentiate subjects with MS from those without MS (model chi-squared = 34.55, p < 0.0001): accuracy = 87.5 %, positive likelihood ratio = 6 (2.09–17.21), negative likelihood ratio = 0.12 (0.03–0.44). Range of sway acceleration amplitude significantly correlated with both ABC (Spearman’s r = −0.567, p = 0.009) and MSWS-12 scores (Spearman’s r = −0.590, p = 0.006). Postural sway abnormalities in subjects with MS who are minimally disabled were detected using wireless inertial sensors and may signify a superior sensitivity to identify balance impairment prior to developing clinically evident disability or impaired gait speed. Further study is needed to confirm the clinical significance and predictive value of these objectively identified balance impairments.