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姿势控制和健康受试者在视-本体感觉前庭-姿势康复前后以及之后 3 个月的双足和单足稳定测试中跌倒的风险:本体感觉系统的作用。

Postural control and risk of falling in bipodalic and monopodalic stabilometric tests of healthy subjects before, after visuo-proprioceptive vestibulo-postural rehabilitation and at 3 months thereafter: role of the proprioceptive system.

机构信息

Department of Neuroscience and Sensory Organs, Otolaryngology-Head and Neck Surgery Unit, S. Filippo Neri Hospital, Rome, Italy.

出版信息

Acta Otorhinolaryngol Ital. 2010 Aug;30(4):182-9.

Abstract

Nine healthy volunteers (6 males, 3 females), mean age 34.5 years (SD = 11.52), underwent a vestibulo-postural rehabilitation cycle with a visuo-proprioceptive-type stimulus. All subjects in the study group were evaluated by means of stabilometric bipodalic and monopodalic tests both before and immediately after treatment, and again 3 month thereafter. The Delos Postural Proprioceptive System®, DPPS (Delos, srl, Turin, Italy), was used in performing these stabilometric tests and in the rehabilitation exercises. The first aim of the study was to evaluate to what extent the functional level of the proprioceptive system was reliable, in healthy subjects, in the control of postural stability; the second was to demonstrate the possibility to increase this level by means of a novel visuo-proprioceptive feedback training; the last was to establish whether or not the increase achieved was permanent. The bipodalic test did not reveal any deficit in posture either before or after rehabilitation. The monopodalic test prior to treatment, with eyes closed, revealed, in 2/3 of the study group, evidence of the risk of falling, expressed as the precautional strategy (8.57 ± 6.18% SD). An increase in the proprioceptive activity, obtained in the subjects examined immediately after the visuo-proprioceptive vestibulo-postural rehabilitation, led, in the monopodalic test, with eyes closed, to a significant reduction in the risk of falling (with the precautional strategy equal to 1.09 ± 2.63% SD, p = 0.004). The monopodalic test, with eyes closed, 3 months after rehabilitation, demonstrated results not unlike those pre-treament with values, therefore, not more significant than those emerging from the pre-treatment test. Thus, from the above-mentioned data, it can be observed that, also in healthy subjects, there may be different levels of postural proprioceptive control related to a high risk of falling. These levels can be maintained constant for a certain period of time, until a significant reduction in the risk of falling is achieved, only if continuously stimulated by appropriate sensorial information.

摘要

九位健康志愿者(6 男 3 女),平均年龄 34.5 岁(标准差=11.52),接受了一种视-本体感觉型刺激的前庭-姿势康复周期。研究组的所有受试者在治疗前、治疗后即刻和 3 个月后均接受双足和单足平衡测试。采用 Delos 姿势本体感觉系统(DPPS)(Delos,srl,都灵,意大利)进行这些平衡测试和康复锻炼。本研究的第一个目的是评估健康受试者的本体感觉系统功能水平在控制姿势稳定性方面的可靠性;第二个目的是证明通过新的视-本体感觉反馈训练提高这一水平的可能性;最后是确定所获得的提高是否是永久性的。双足测试在康复前后均未显示出任何姿势缺陷。在治疗前进行的闭眼单足测试显示,在研究组的 2/3 中,存在跌倒风险的证据,表现为预防策略(8.57±6.18%标准差)。在视-本体感觉前庭-姿势康复后立即进行的检查中,本体感觉活动的增加导致闭眼单足测试中跌倒风险显著降低(预防策略等于 1.09±2.63%标准差,p=0.004)。康复 3 个月后进行的闭眼单足测试结果与治疗前相似,因此,与治疗前测试相比,没有更显著的结果。因此,从上述数据可以看出,即使在健康受试者中,也可能存在与高跌倒风险相关的不同水平的姿势本体感觉控制。只有通过持续刺激适当的感觉信息,这些水平才能在一定时间内保持不变,直到跌倒风险显著降低。

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