Vanicek Natalie, Strike Siobhan, McNaughton Lars, Polman Remco
Department of Sport, Health and Exercise Science, University of Hull, Hull, UK.
Arch Phys Med Rehabil. 2009 Jun;90(6):1018-25. doi: 10.1016/j.apmr.2008.12.024.
To quantify postural responses in amputee fallers versus nonfallers by using computerized dynamic posturography.
All participants completed standard protocols on the Sensory Organization Test (SOT) and Motor Control Test (MCT) of the NeuroCom Equitest.
Human performance laboratory in a university in the United Kingdom.
Transtibial amputees (n=9) and able-bodied subjects (n=9) (all categorized into fallers and nonfallers according to their falls history in the previous 9 mo).
Not applicable.
Equilibrium and strategy scores on the SOT. Postural response latency and weight distribution on the MCT.
Equilibrium scores were highest when somatosensory information was accurate, but there were no differences between the groups. Strategy scores were lower when visual cues and somatosensory information were inaccurate, and the fallers and nonfallers used a combination of ankle and hip strategies to prevent a loss of balance. The amputee nonfallers indicated they had a greater reliance on visual input even when it was inaccurate compared with the amputee fallers, whereas the control fallers used the hip strategy significantly more compared with the control nonfallers (SOT condition 6: 56+/-22 vs 72+/-10, P=.01). Weight distribution symmetry showed that the amputee nonfallers bore significantly more weight through their intact limb compared with the amputee fallers during backward and forward translations (P<.05).
The SOT and MCT appeared to be population specific and therefore did not reliably identify fallers among transtibial amputees or distinguish between community-dwelling control fallers and nonfallers. Amputee and control fallers can prevent a fall during challenging static and dynamic conditions by adapting their neuromuscular responses. The results from this study have important implications for amputee gait rehabilitation, falls prevention, and treatment programs.
通过使用计算机化动态姿势描记法，对截肢者跌倒者与非跌倒者的姿势反应进行量化。
所有参与者均完成了NeuroCom Equitest的感觉组织测试（SOT）和运动控制测试（MCT）的标准方案。
英国一所大学的人体性能实验室。
经胫截肢者（n = 9）和健全受试者（n = 9）（根据他们在过去9个月中的跌倒史，均分为跌倒者和非跌倒者）。
不适用。
SOT上的平衡和策略得分。MCT上的姿势反应潜伏期和体重分布。
当体感信息准确时，平衡得分最高，但两组之间无差异。当视觉线索和体感信息不准确时，策略得分较低，跌倒者和非跌倒者使用踝关节和髋关节策略的组合来防止失去平衡。与截肢跌倒者相比，截肢非跌倒者表示即使视觉输入不准确，他们对视觉输入的依赖也更大，而对照组跌倒者与对照组非跌倒者相比，使用髋关节策略的比例明显更高（SOT条件6：56±22 vs 72±10，P = .01）。体重分布对称性表明，在向后和向前平移过程中，与截肢跌倒者相比，截肢非跌倒者通过其健全肢体承受的体重明显更多（P <.05）。
SOT和MCT似乎具有人群特异性，因此不能可靠地识别经胫截肢者中的跌倒者，也无法区分社区居住的对照跌倒者和非跌倒者。截肢者和对照跌倒者可以通过调整神经肌肉反应，在具有挑战性的静态和动态条件下预防跌倒。本研究结果对截肢者步态康复、跌倒预防和治疗方案具有重要意义。
