Zamysłowska-Szmytke Ewa, Sliwińska-Kowalska Mariola
Instytut Medycyny Pracy im. prof. J. Nofera, Łódź, Klinika Audiologii i Foniatrii, Pracownia Zaburzeń Równowagi.
Med Pr. 2011;62(3):237-46.
Balance assessment plays an important role in occupational medicine. The diagnosis of patients with balance disturbances is based on a number of laboratory tests, including rotational chair tests, one of the most important. The normative value of kinetic tests greatly depends on movement parameters and laboratory equipment, which vary between diagnostic centers. The aim of the presented paper was to establish normatives for our laboratory and testing methodology in a group of healthy persons.
The balance examination included 45 healthy persons (21 women and 24 men) aged 20-63 years (mean 38.5 +/- 14.9). The study population underwent very thorough neuro-otological examination, static posturography and VNG tests. The caloric test result was a crucial criterion for inclusion to the group of healthy persons. Rotational tests included: one "burst" test analyzing vestibulo-ocular reflex (VOR) with and without optokinetic stimulation visual vestibular optokinetic reflex (VVOR) and cervico-ocular reflex (COR); three impulse tests and sinusoidal harmonic rotation tests of 0.04, 0.08, 0.1, 0.16, 0.32, and 0.64 Hz.
The mean values were: VVOR, 0.9 +/- 0.1; VOR, 0.5 +/- 0.1; and COR, 0.2 +/- 0.1. The mean value of rotational and post-rotational nystagmus induced by sudden chair stop (impulse stimulus) was 9 +/- 7 s, the gain values were 0.4 for sinusoidal tests, in the stimulation range of 0.1-0.32 and 0.5 for 0.64 Hz stimulation. There was no significant linear relationship between age and test parameters except for the test using sinusoidal-decreasing stimulation.
These normative values form the base for a closer incorporation of rotational tests in occupational medicine procedures.
平衡评估在职业医学中起着重要作用。平衡障碍患者的诊断基于多项实验室检查,其中旋转椅试验是最重要的检查之一。动力学检查的标准值很大程度上取决于运动参数和实验室设备,而这些在不同诊断中心之间存在差异。本文的目的是为我们实验室在一组健康人群中建立测试方法的标准值。
平衡检查纳入了45名年龄在20 - 63岁(平均38.5 +/- 14.9岁)的健康人(21名女性和24名男性)。研究人群接受了非常全面的神经耳科学检查、静态姿势描记法和视频眼震图(VNG)检查。冷热试验结果是纳入健康人群组的关键标准。旋转试验包括:一项“爆发”试验,分析有无视动刺激时的前庭眼反射(VOR)、视前庭视动反射(VVOR)和颈眼反射(COR);三项脉冲试验以及频率为0.04、0.08、0.1、0.16、0.32和0.64 Hz的正弦谐波旋转试验。
平均值分别为:VVOR为0.9 +/- 0.1;VOR为0.5 +/- 0.1;COR为0.2 +/- 0.1。突然停止椅子(脉冲刺激)诱发的旋转性和旋转后眼震的平均值为9 +/- 7秒,正弦试验的增益值在0.1 - 0.32刺激范围内为0.4,在0.64 Hz刺激时为0.5。除了使用正弦递减刺激的试验外,年龄与试验参数之间没有显著的线性关系。
这些标准值为在职业医学程序中更紧密地纳入旋转试验奠定了基础。