Karst Gregory M, Venema Dawn M, Roehrs Tammy G, Tyler Amy E
Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, NE, USA.
J Neurol Phys Ther. 2005 Dec;29(4):170-80. doi: 10.1097/01.npt.0000282314.40230.40.
Balance impairments are common in persons with multiple sclerosis (MS), but clinical balance tests may not detect subtle deficits in adults with MS who are not yet experiencing functional limitations or disability. The purpose of this study was to determine if center of pressure (COP) displacement during standing tasks could be a useful performance-based evaluative measure for adults with MS who have minimal or no balance deficits on clinical examination using the Berg Balance Scale (BBS).
Twenty-one adults with MS were compared with 21 age- and gendermatched healthy adults. Subjects with MS were tested with the BBS, Mini-mental State Exam, Expanded Disability Status Scale (EDSS), and Multiple Sclerosis Functional Composite (MSFC). They also performed voluntary leaning and reaching movements while kinematic and kinetic data were collected. Control subjects performed the same tasks with the exception of the EDSS and MSFC.
COP displacement during reaching and leaning was less in adults with MS when compared to control subjects. There were no differences in anthropometric, kinematic, or foot position variables that could account for this difference. Furthermore, there was no difference between groups when COP displacement during reaching was expressed as a percentage of the maximum COP displacement during leaning.
COP measures show clear differences when comparing healthy adults with minimally impaired adults with MS. The lack of between-group differences when COP displacement during reaching was expressed as a percentage of the maximum COP displacement during leaning suggests that the subjects with MS adopt a reaching strategy that allows them to stay within their reduced limits of stability. COP measures during standing tasks appear well-suited to quantifying changes in postural control over time or in response to intervention for minimally impaired persons with MS.
平衡功能障碍在多发性硬化症（MS）患者中很常见，但临床平衡测试可能无法检测出尚未出现功能受限或残疾的成年MS患者的细微缺陷。本研究的目的是确定在站立任务期间的压力中心（COP）位移是否可以作为一种基于表现的评估指标，用于临床检查中使用伯格平衡量表（BBS）时平衡缺陷最小或无平衡缺陷的成年MS患者。
将21名成年MS患者与21名年龄和性别匹配的健康成年人进行比较。对MS患者进行BBS、简易精神状态检查、扩展残疾状态量表（EDSS）和多发性硬化症功能综合评分（MSFC）测试。他们还在收集运动学和动力学数据的同时进行了自愿倾斜和伸展动作。对照组除了不进行EDSS和MSFC测试外，执行相同的任务。
与对照组相比，MS患者在伸展和倾斜时的COP位移较小。人体测量学、运动学或足部位置变量方面没有差异可以解释这种差异。此外，当将伸展时的COP位移表示为倾斜时最大COP位移的百分比时，两组之间没有差异。
在比较健康成年人与轻度受损的成年MS患者时，COP测量显示出明显差异。当将伸展时的COP位移表示为倾斜时最大COP位移的百分比时，组间无差异，这表明MS患者采用了一种伸展策略，使他们能够保持在降低的稳定极限范围内。站立任务期间的COP测量似乎非常适合量化随着时间的推移或对轻度受损的MS患者进行干预后姿势控制的变化。
