Department of Biomedical Engineering, University Hospital Maastricht, The Netherlands.
Gait Posture. 2010 Feb;31(2):213-7. doi: 10.1016/j.gaitpost.2009.10.008. Epub 2009 Nov 18.
This study explores the effect of vibrotactile biofeedback on body sway in stance in patients with severe bilateral vestibular losses in a placebo-controlled study. A tilt sensor mounted on the head or trunk is used to detect head or body tilt and activates via a microprocessor 12 small vibrators that are placed around the waist with a mutual distance of 30 degrees. Two positions of the tilt sensor (head and trunk) and three types of biofeedback (normal, full and random) were evaluated, besides no biofeedback. Body sway during stance was assessed in 10 patients with bilateral vestibular areflexia and performance was scored in the seven different conditions. Inter-individual and test-retest variability without biofeedback was assessed in 10 additional patients with bilateral vestibular areflexia. In six patients no significant change in body swaypath was observed using biofeedback. In four patients body swaypath decreased significantly using biofeedback and sensor on the head in all three activation modes, whereas with sensor on the trunk only one patient showed a significant improvement in swaypath in all three activation modes. The patients rated the functionality of the AVBF system and its effect on balance on average 6.5 on a scale from 0 to 10. Thus, body sway improved in 4 out of 10 patients using biofeedback, but the improvement with true biofeedback was only observed in those subjects where an improvement was present in placebo mode as well. The improvement was, at least partially, caused by other effects than biofeedback, like training, increased self-confidence or alertness.
本研究采用安慰剂对照试验，探讨振动触觉生物反馈对严重双侧前庭损失患者站立位身体摆动的影响。通过微处理器，使用安装在头部或躯干上的倾斜传感器来检测头部或身体倾斜，并激活放置在腰部周围的 12 个小振动器，彼此之间的距离为 30 度。评估了倾斜传感器的两个位置（头部和躯干）和三种生物反馈类型（正常、完全和随机），以及没有生物反馈的情况。在 10 名双侧前庭反射消失的患者中评估了站立时的身体摆动，并在 7 种不同条件下进行了评分。在另外 10 名双侧前庭反射消失的患者中，评估了无生物反馈时的个体间和测试-再测试变异性。在 6 名患者中，使用生物反馈时身体摆动路径没有明显变化。在 4 名患者中，使用生物反馈和头部传感器时，所有三种激活模式下的身体摆动路径都显著减小，而在躯干传感器上，只有一名患者在所有三种激活模式下的摆动路径都显著改善。患者平均将 AVBF 系统的功能及其对平衡的影响评为 6.5（0 到 10 的评分）。因此，使用生物反馈的 10 名患者中有 4 名的身体摆动得到改善，但只有在安慰剂模式下也有改善的患者中才观察到真正的生物反馈的改善。这种改善至少部分是由生物反馈以外的其他因素引起的，例如训练、增强的自信心或警觉性。
