Manckoundia P, Pérennou D, Pfitzenmeyer P, Mourey F
Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France.
Rev Med Interne. 2007 Apr;28(4):242-9. doi: 10.1016/j.revmed.2006.12.002. Epub 2007 Jan 9.
Although there is currently no epidemiological data on backward disequilibrium, this disturbance of posture does not seem to be rare in frail elderly.
Backward disequilibrium is characterized by the following criteria: the location of buttocks on the anterior side of the seat while the trunk rested at the back of the armchair in the sitting position; an inadequate forward of the trunk and a backward projection of the trunk outside the base of support during sit-to-stand; and a posterior projection of the center of mass outside the base of support in the standing position. Several pathological situations either somatic (degenerative, ischemic and traumatic brain lesions), psycho-somatic (psychomotor disadaptation syndrome, extended bed confining, non-use) or psychological (depression) affections can entail backward disequilibrium. Falls, loss of autonomy and the risk of the vicious circle with its causes are the main consequences of backward disequilibrium.
Although the geriatrician is familiarized with backward disequilibrium, there is no scale to quantify it. In this paper we review causes, consequences and management of backward disequilibrium, and in order to assess it, we propose a semi-quantitative scale, based on some activities of everyday living which are sitting position, sit-to-stand, back-to-sit and standing position. So, a backward disequilibrium score could be determined.
尽管目前尚无关于后向失衡的流行病学数据，但这种姿势紊乱在体弱老年人中似乎并不罕见。
后向失衡的特征如下标准：坐姿时臀部位于座椅前侧，而躯干靠在扶手椅靠背上；从坐到站过程中躯干向前移动不足且躯干向后超出支撑面；站立位时重心后移至支撑面外。多种病理情况，包括躯体性（退行性、缺血性和创伤性脑损伤）、心身性（精神运动适应不良综合征、长期卧床限制、废用）或心理性（抑郁）疾病，都可能导致后向失衡。跌倒、自主性丧失以及恶性循环及其病因带来的风险是后向失衡的主要后果。
尽管老年病医生对后向失衡有所了解，但尚无用于量化它的量表。在本文中，我们回顾了后向失衡的病因、后果及管理方法，并且为了评估它，我们基于一些日常生活活动（即坐姿、坐到站、背到坐和站立位）提出了一个半定量量表。这样，就可以确定一个后向失衡评分。
