Patterns of balance loss with systematic perturbations in Parkinson's disease and multiple sclerosis.
Patterns of balance loss with systematic perturbations in Parkinson's disease and multiple sclerosis.
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DOI：
10.3233/nre-210200
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发表时间：
2021
影响因子：
2
通讯作者：
Widener GL
中科院分区：
文献类型：
--
作者：
Allen DD;Gadayan J;Hughes R;Magdalin C;Jang C;Schultz A;Scott K;Vivero L;Lazaro RL;Widener GL
多发性硬化症（MS）和帕金森病（PD）可能会影响平衡不同。然而，没有研究比较多方向扰动后的平衡丧失（LOB）模式。1)确定标准化手动扰动后LOB评级的可靠性; 2）比较MS、PD和健康对照（HC）组在上/下躯干、前/后、右/左和旋转方向扰动后的LOB评级。1)在4名临床医生在6-10个HC中施加扰动后，审查者对录像的LOB进行评级。2)三组（64名MS、42名PD和32名HC）接受扰动。使用双因素混合方差分析的幅度和患病率的LOB评级扰动。1)LOB评级显示中度至良好的ICC和良好至极好的一致性。2)MS组的LOB程度和患病率高于PD或HC组（p <.001）。 所有组均显示来自右/左扰动的LOB大于来自前/后扰动的LOB（p <0.01）。 PD显示上部与下部躯干扰动的LOB更大; MS和HC显示后部与前部扰动的LOB更大。我们可靠的评定量表显示MS、PD和HC手动扰动后LOB模式的差异。临床上可获得的和可靠的LOB评估可以促进有针对性的干扰为基础的干预措施，并减少福尔斯在脆弱人群。
Multiple sclerosis (MS) and Parkinson’s disease (PD) may affect balance differently. However, no studies have compared loss of balance (LOB) patterns following multi-directional perturbations. 1) determine reliability of LOB ratings following standardized manual perturbations; 2) compare LOB ratings in MS, PD, and healthy control (HC) groups following perturbations at upper/lower torso, in anterior/posterior, right/left, and rotational directions. 1) reviewers rated videotaped LOB following perturbations applied by 4 clinicians in 6–10 HCs. 2) three groups (64 MS, 42 PD and 32 HC) received perturbations. LOB ratings following perturbations were analyzed using two-factor mixed ANOVAs for magnitude and prevalence. 1) LOB ratings showed moderate to good ICC and good to excellent agreement. 2) MS group showed greater magnitude and prevalence of LOB than PD or HC groups (p < .001). All groups showed greater LOB from right/left versus anterior/posterior perturbations (p < .01). PD showed greater LOB from perturbations at upper versus lower torso; MS and HC showed greater LOB from posterior versus anterior perturbations. Our reliable rating scale showed differences in patterns of LOB following manual perturbations in MS, PD, and HC. Clinically accessible and reliable assessment of LOB could facilitate targeted perturbation-based interventions and reduce falls in vulnerable populations.