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振动感觉阈值与老年人姿势控制和跌倒风险评估的关系。

Vibration perception threshold in relation to postural control and fall risk assessment in elderly.

机构信息

Department of Rehabilitation Sciences and Physiotherapy and.

出版信息

Disabil Rehabil. 2013 Sep;35(20):1712-7. doi: 10.3109/09638288.2012.751136. Epub 2013 Apr 19.

Abstract

PURPOSE

This study investigates (i) the potential discriminative role of a clinical measure of peripheral neuropathy (PN) in assessing postural performance and fall risk and (ii) whether the integration of a simple screening vibration perception threshold (VPT) for PN in any physical (fall risk) assessment among elderly should be recommended, even if they do not suffer from DM.

METHOD

One hundred and ninety-five elderly were entered in a four-group model: DM with PN (D+; n = 75), DM without PN (D-; n = 28), non-diabetic elderly with idiopathic PN (C+; n = 31) and non-diabetic elderly without PN (C-; n = 61). Posturographic sway parameters were captured during different static balance conditions (AMTI AccuGait, Watertown, MA). VPT, fall data, Mini-Mental State Examination and Clock Drawing Test were registered. Two-factor repeated-measures ANOVA was used to compare between groups and across balance conditions.

RESULTS

The groups with PN demonstrated a strikingly comparable, though bigger sway, and a higher prospective fall incidence than their peers without PN.

CONCLUSIONS

The indication of PN, irrespective of its cause, interferes with postural control and fall incidence. The integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. Implications for Rehabilitation The indication of peripheral neuropathy (PN), irrespective of its cause, interferes with postural control and fall incidence. Therefore, the integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. It might be useful to integrate somatosensory stimulation in rehabilitation programs designed for fall prevention.

摘要

目的

本研究旨在(i)探讨一种外周神经病变(PN)的临床测量方法在评估姿势表现和跌倒风险方面的潜在鉴别作用,以及(ii)即使没有糖尿病的老年人没有患 PN,是否应该推荐在任何针对老年人的物理(跌倒风险)评估中纳入简单的 PN 筛查振动感觉阈值(VPT)。

方法

195 名老年人被纳入了一个四组模型:有 PN 的糖尿病(D+;n=75)、无 PN 的糖尿病(D-;n=28)、特发性 PN 的非糖尿病老年人(C+;n=31)和无 PN 的非糖尿病老年人(C-;n=61)。在不同的静态平衡条件下(AMTI AccuGait,沃特敦,MA)记录了动觉图的摆动参数。记录了 VPT、跌倒数据、简易精神状态检查和时钟绘制测试。采用双因素重复测量方差分析比较组间和平衡条件下的差异。

结果

PN 组的摆动幅度明显更大,但与无 PN 组的摆动幅度相当,且前瞻性跌倒发生率更高。

结论

无论其病因如何,PN 的出现都会干扰姿势控制和跌倒发生率。强烈建议在任何老年人跌倒风险评估中纳入简单的 PN 筛查(如生物感觉阈值测定法)。

康复意义

无论其病因如何,周围神经病变(PN)的表现都会干扰姿势控制和跌倒发生率。因此,强烈建议在任何老年人跌倒风险评估中纳入简单的 PN 筛查(如生物感觉阈值测定法)。在设计预防跌倒的康复计划时,整合体感刺激可能会很有用。

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