Failure on the Foam Eyes Closed Test of Standing Balance Associated With Reduced Semicircular Canal Function in Healthy Older Adults
Failure on the Foam Eyes Closed Test of Standing Balance Associated With Reduced Semicircular Canal Function in Healthy Older Adults
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DOI：
10.1097/aud.0000000000000619
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发表时间：
2019-03-01
期刊：
影响因子：
3.7
通讯作者：
Agrawal, Yuri
中科院分区：
文献类型：
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作者：
Anson, Eric;Bigelow, Robin T.;Agrawal, Yuri
目标：闭眼站在泡沫上（FOEC）已被描述为前庭功能的衡量标准；然而，前庭功能和本体感觉功能对 FOEC 测试的相对贡献尚未得到很好的描述。在这项研究中，作者调查了一组健康成年人的外周感觉系统（前庭和本体感觉）与 FOEC 测试表现之间的关系。设计：对参与巴尔的摩老龄化纵向研究的总共 563 名社区居住的健康成年人（平均年龄，72.7 [SD，12.6] 岁；范围，27 至 93 岁）进行了测试。通过右脚踝处的被动运动检测来评估本体感觉阈值（PROP）。使用视频头脉冲测量前庭眼反射 (VOR) 增益。耳石功能通过颈部和眼部前庭诱发肌源性电位进行测量。参与者佩戴 BalanSens（BioSensics，LLC，Watertown，MA）在 FOEC 上站立 40 秒，以量化质量中心摇摆面积。在控制年龄和性别的情况下，使用混合模型多元逻辑回归来检查通过基于多感觉模型中的 PROP、VOR、颈部前庭诱发肌源性电位和眼部前庭诱发肌源性电位功能的 FOEC 测试的几率。结果：年龄每增加一年，通过 FOEC 测试的几率就会降低 15% (p < 0.001)，VOR 增益每减少 0.1，通过 FOEC 测试的几率就会降低 8% (p = 0.025)。 PROP 和耳石功能均与通过 FOEC 测试没有显着相关性。结论：FOEC 期间未能保持平衡可能可以作为旋转前庭对姿势控制贡献的代表。半规管比耳石对低频运动更敏感，这可以解释这些关系，因为站立摇摆是由较低频率主导的。较低的 VOR 增益和年龄的增加分别降低了通过测试的几率。
Objectives: Standing on foam with eyes closed (FOEC) has been characterized as a measure of vestibular function; however, the relative contribution of vestibular function and proprioceptive function to the FOEC test has not been well described. In this study, the authors investigate the relationship between peripheral sensory systems (vestibular and proprioception) and performance on the FOEC test in a cohort of healthy adults. Design: A total of 563 community-dwelling healthy adults (mean age, 72.7 [SD, 12.6] years; range, 27 to 93 years) participating in the Baltimore Longitudinal Study of Aging were tested. Proprioceptive threshold (PROP) was evaluated with passive motion detection at the right ankle. Vestibulo-ocular reflex (VOR) gain was measured using video head impulses. Otolith function was measured with cervical and ocular vestibular-evoked myogenic potentials. Participants stood on FOEC for 40 sec while wearing BalanSens (BioSensics, LLC, Watertown, MA) to quantify center of mass sway area. A mixed-model multiple logistic regression was used to examine the odds of passing the FOEC test based on PROP, VOR, cervical vestibular-evoked myogenic potential, and ocular vestibular-evoked myogenic potential function in a multisensory model while controlling for age and gender. Results: The odds of passing the FOEC test decreased by 15% (p < 0.001) for each year of increasing age and by 8% with every 0.1 reduction in VOR gain (p = 0.025). Neither PROP nor otolith function was significantly associated with passing the FOEC test. Conclusions: Failure to maintain balance during FOEC may serve as a proxy for rotational vestibular contributions to postural control. Semicircular canals are more sensitive to low-frequency motion than otoliths that may explain these relationships because standing sway is dominated by lower frequencies. Lower VOR gain and increased age independently decreased the odds of passing the test.