Sjöström Henrik, Allum John H J, Carpenter Mark G, Adkin Allan L, Honegger Flurin, Ettlin Thierry
Department of ORL, Universtity Hospital, Basel, Switzerland.
Spine (Phila Pa 1976). 2003 Aug 1;28(15):1725-34. doi: 10.1097/01.BRS.0000083170.34304.A3.
Trunk sway occurring during clinical stance and gait tasks was compared between a group of subjects with a chronic whiplash injury, resulting from an automobile collision, and a normal collective.
To examine if population specific trunk sway patterns for stance and gait could be identified for chronic whiplash injury patients.
Our previous work has established that it is possible to identify specific patterns of stance and gait deficits for vestibular loss (both acute and compensated) patients and those with Parkinson's disease. Our question was whether it was possible to use the same stance and gait tasks to identify patterns of trunk sway differences with respect to those of healthy subjects and individuals with a chronic whiplash injury.
Twenty-five subjects with history of whiplash injury and 170 healthy age-matched control subjects participated in the study. Trunk sway angular displacements in chronic whiplash patients were assessed for a number of stance and gait tasks similar to those of the Tinetti and Clinical Test of Sensory Interaction and Balance (CTSIB) protocols. We used a lightweight, easy-to-attach, body-worn apparatus to measure trunk angular displacements and velocities in the roll (lateral) and the pitch (forward-backward) planes.
Data analysis revealed several significant differences between the two groups. A pattern could be identified, showing greater trunk sway for stance tasks and for complex gait tasks that required task-specific gaze control such as walking up and down stairs. Trunk sway was less, however, for simple gait tasks that demanded large head movements but no task-specific gaze control, such as walking while rotating the head.
Subjects who have a chronic whiplash injury show a characteristic pattern of trunk sway that is different from that of other patient groups with balance disorders. Balance was most unstable during gait involving task-specific head movements which possibly enhance a pathologic vestibulo-cervical interaction.
比较一组因汽车碰撞导致慢性挥鞭伤的受试者与正常对照组在临床站立和步态任务期间的躯干摆动情况。
检查是否能为慢性挥鞭伤患者确定特定的站立和步态躯干摆动模式。
我们之前的研究已经确定，对于前庭功能丧失（急性和代偿性）患者以及帕金森病患者，可以识别出特定的站立和步态缺陷模式。我们的问题是，是否可以使用相同的站立和步态任务来识别慢性挥鞭伤患者与健康受试者在躯干摆动差异方面的模式。
25名有挥鞭伤病史的受试者和170名年龄匹配的健康对照受试者参与了该研究。对慢性挥鞭伤患者的躯干摆动角位移进行评估，采用了一些类似于Tinetti测试以及感觉交互和平衡临床测试（CTSIB）方案中的站立和步态任务。我们使用了一种轻便、易于附着的身体穿戴设备来测量躯干在横滚（侧向）和俯仰（前后）平面的角位移和速度。
数据分析显示两组之间存在若干显著差异。可以识别出一种模式，即对于站立任务以及需要特定任务注视控制的复杂步态任务（如下楼梯和上楼梯），慢性挥鞭伤患者的躯干摆动更大。然而，对于需要大幅度头部运动但不需要特定任务注视控制的简单步态任务（如转头行走），躯干摆动较小。
患有慢性挥鞭伤的受试者表现出一种独特的躯干摆动模式，与其他患有平衡障碍的患者群体不同。在涉及特定任务头部运动的步态中，平衡最不稳定，这可能会增强病理性前庭 - 颈部相互作用。
