Increased roll tilt thresholds are associated with subclinical postural instability in asymptomatic adults aged 21 to 84 years.
Increased roll tilt thresholds are associated with subclinical postural instability in asymptomatic adults aged 21 to 84 years.
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在21 - 84岁无症状成人中，增加的侧倾阈值与亚临床姿势不稳定相关。
DOI：
10.3389/fnagi.2023.1207711
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发表时间：
2023
影响因子：
4.8
通讯作者：
中科院分区：
文献类型：
--
作者：
有意改变视觉和本体感受反馈可靠性的平衡评估（例如，闭着眼睛站在泡沫上）已经成为鉴定老年人前庭介导的平衡功能障碍的标准方法。然而，这种评估不能辨别前庭系统的哪个特定元件（例如，半规管，耳石，或联合管耳石）的基础上观察到的年龄相关的平衡性能的变化。本研究旨在确定特定来源的前庭噪声和定量措施的安静的立场姿势控制标准的“前庭”平衡条件下测量之间的关联。一组52名无前庭或神经系统疾病史的无症状成人（53.21 ± 19.7，21 - 84岁）自愿参加本研究。我们测量了一组五个前庭感知阈值，分析前庭噪声的主要贡献，从垂直运河，侧运河，椭圆囊，球囊，和中央集成的运河耳石信号。此外，参与者完成了两个标准的平衡评估，每个评估的目的是优先考虑使用前庭线索的安静站立姿势控制-闭上眼睛的泡沫（条件4的修改Romberg平衡测试）和闭上眼睛，在摇摆参考支持表面（条件5的感觉组织测试）。在年龄调整模型中，我们发现侧倾前庭阈值（中央综合耳道-耳石信号中的噪声测量）与前后和内外侧压力中心（CoP）的均方根距离（RMSD）之间存在强烈的正相关性。侧倾阈值与CoP的RMSD之间的关联强度比姿势摇摆与测量的其他前庭阈值之间的关联大3倍至30倍。我们认为，噪声在中央估计耳道“倾斜”信号可能是亚临床姿势不稳定的老年人在“前庭”条件的平衡评估的主要驱动程序。需要在临床平衡障碍的成人中进行额外的测试，以确定侧倾阈值是否也可以作为检测前庭介导的平衡功能障碍和/或跌倒风险的替代指标。
Balance assessments that intentionally alter the reliability of visual and proprioceptive feedback (e.g., standing on foam with eyes closed) have become a standard approach for identifying vestibular mediated balance dysfunction in older adults. However, such assessments cannot discern which specific element of the vestibular system (e.g., semicircular canal, otolith, or combined canal-otolith) underlies the observed age-related changes in balance performance. The present study was designed to determine the associations between specific sources of vestibular noise and quantitative measures of quiet stance postural control measured during standard “vestibular” balance conditions. A group of 52 asymptomatic adults (53.21 ± 19.7, 21 to 84 years) without a history of vestibular or neurologic disorders volunteered for this study. We measured a battery of five vestibular perceptual thresholds that assay vestibular noise with predominant contributions from the vertical canals, lateral canals, utricles, saccules, and the centrally integrated canal-otolith signal. In addition, participants completed two standard balance assessments that were each designed to prioritize the use of vestibular cues for quiet stance postural control—eyes closed on foam (Condition 4 of the Modified Romberg Balance Test) and eyes closed, on a sway referenced support surface (Condition 5 of the Sensory Organization Test). In age adjusted models, we found strong positive associations between roll tilt vestibular thresholds, a measure of noise in the centrally integrated canal-otolith signal, and the root mean square distance (RMSD) of the anteroposterior and mediolateral center of pressure (CoP) captured during eyes closed stance on a sway referenced support surface. The strength of the association between roll tilt thresholds and the RMSD of the CoP was between 3-times and 30-times larger than the association between postural sway and each of the other vestibular thresholds measured. We posit that noise in the centrally estimated canal-otolith “tilt” signal may be the primary driver of the subclinical postural instability experienced by older adults during the “vestibular” conditions of balance assessments. Additional testing in adults with clinical balance impairment are needed to identify if roll tilt thresholds may also serve as a surrogate metric by which to detect vestibular mediated balance dysfunction and/or fall risk.
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DOI：
10.3389/fresc.2023.1166859
发表时间：
2023
期刊：
FRONTIERS IN REHABILITATION SCIENCES
影响因子：
--
作者：
Wagner, Andrew R.;Merfeld, Daniel M.
通讯作者：
Merfeld, Daniel M.
影响因子：
--
作者：
Deshpande, Nandini;Simonsick, Eleanor;Studenski, Stephanie
通讯作者：
Studenski, Stephanie
影响因子：
3.4
作者：
Evans, MK;Krebs, DE
通讯作者：
Krebs, DE
影响因子：
4.6
作者：
Gabriel, Grace A.;Harris, Laurence R.;Gnanasegaram, Joshua J.;Cushing, Sharon L.;Gordon, Karen A.;Haycock, Bruce C.;Campos, Jennifer L.
通讯作者：
Campos, Jennifer L.
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y