Minimally important differences for subjective improvement in postural stability in patients with bilateral vestibulopathy
Minimally important differences for subjective improvement in postural stability in patients with bilateral vestibulopathy
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双侧前庭病患者姿势稳定性主观改善的最小重要差异
DOI：
10.1016/j.neulet.2021.135706
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发表时间：
2021
影响因子：
2.5
通讯作者：
Iwasaki Shinichi
中科院分区：
文献类型：
--
作者：
Fujimoto Chisato;Kawahara Takuya;Kinoshita Makoto;Ichijo Kentaro;Oka Mineko;Kamogashira Teru;Sugasawa Keiko;Yamasoba Tatsuya;Iwasaki Shinichi
目的探讨双侧前庭病变（BVP）患者在接受治疗干预后，体位稳定性主观改善的最小重要差异（mid）。方法对13例BVP患者进行嘈杂前庭电刺激（nGVS） 30 min，观察刺激后闭眼静位。测量了压力中心（COP）运动的速度，COP运动所包围的面积以及COP位移的均方根（RMS）。与未进行nGVS测量的姿势稳定性相比，nGVS后的姿势稳定性主观评价分为恶化、轻微恶化、不变、轻微改善和改善。采用基于锚定的方法来估计MIDs的主观改善。对每个锚反应组的速度、面积和均方根取平均值（2次，每次在刺激后3小时内测量5次）。轻度改善组和未改变组之间的平均变化用作MID改善的估计值。结果共分析了129个锚点。主观评价有83人（64%）认为没有变化，33人（26%）认为略有改善。基于锚点的方法得出的MIDs的速度改善为-0.43 cm/s (p< 0.01)，面积改善为-0.77 cm/s (p< 0.01)， RMS改善为-0.23 cm （p< 0.001）。结论本研究提供了改善BVP患者姿势稳定性的MIDs估计，可能有助于解释临床试验结果在未来的研究中是否有意义。
ObjectiveTo determine minimally important differences (MIDs) for subjective improvement in postural stability after a therapeutic intervention in patients with bilateral vestibulopathy (BVP).MethodsThirteen BVP patients received noisy galvanic vestibular stimulation (nGVS) for 30 min and their static posture with eyes closed was monitored after the stimuli. The velocity of the center of pressure (COP) movement, the area enclosed by the COP movement, and the root mean square (RMS) of the displacement of the COP were measured for 30 s. Subjective evaluation of postural stability after nGVS was graded as worsened, slightly worsened, unchanged, slightly improved and improved in comparison with postural stability measured without nGVS. Anchor-based methods were used to estimate MIDs for subjective improvement. Velocity, area and RMS for each anchor-response group were averaged (2 sessions, each with 5 measurement periods during 3 h after the stimuli). The mean changes between the slightly improved group and unchanged group were used as estimates for MID for improvement.ResultsA total of 129 anchors were analyzed. Subjective evaluations numbered 83 (64%) for unchanged and 33 (26%) for slightly improved. Anchor-based methods yielded estimates for MIDs of -0.43 cm/s in velocity improvement (p< 0.01), -0.77 cm2for area improvement (p< 0.01) and -0.23 cm for RMS improvement (p< 0.001).ConclusionThe present study provides the estimation of MIDs for improving postural stability in BVP patients and may be useful for interpreting whether the results from clinical trials are meaningful in future studies.