Rossi-Izquierdo Marcos, Basta Dietmar, Rubio-Rodríguez Juan Pedro, Santos-Pérez Sofía, Ernst Arne, Sesar-Ignacio Ángel, Alberte-Woodward Miguel, Guijarro-Del Amo Mónica, Estany-Gestal Ana, San Román-Rodríguez Elena, Faraldo-García Ana, Zubizarreta-Gutiérrez Alfonso, Soto-Varela Andrés
Department of Otolaryngology, University Hospital Lucus Augusti, Spain.
Department of Otolaryngology at UKB, Hospital of the University of Berlin, Charité Medical School, Berlin, Germany.
Gait Posture. 2014;40(1):53-7. doi: 10.1016/j.gaitpost.2014.02.003. Epub 2014 Feb 20.
Parkinson' disease (PD) is one of the most prevalent neurodegenerative diseases, and more than half of patients with PD experience falls. Research for clinically useful risk factors predicting falls has yielded inconsistent findings so far. Hence the aim of the study is to validate two different posturography techniques and one modified-timed up and go test (TUG) in discriminating fallers and non-fallers among PD patients.
32 patients diagnosed with idiopathic PD were assessed with: Dizziness handicap inventory, Activities-specific balance confidence scale, modified-TUG, sensorial organization test (SOT) and limits of stability (LOS) of computer dynamic posturography, results of free-field body sway analysis with Vertiguard device and number of falls.
Fallers had longer time to perform modified-TUG and required more steps. On average, fallers performed SOT and LOS significantly worse and Vertiguard device indicated a higher risk of falling. Based on the area under the curve of receiver operating characteristics analyses, the overall accuracy of directional control of LOS and steps in modified-TUG are close to 0.9 (high accuracy). Also assessment with Vertiguard device is more efficient in identifying fallers than the parameters of SOT.
Our results indicate that LOS, mobile posturography (Vertiguard), vestibular input of SOT and number of steps taken in modified-TUG are very useful to identify fallers in PD patients.
帕金森病(PD)是最常见的神经退行性疾病之一,超过半数的帕金森病患者会跌倒。迄今为止,关于预测跌倒的临床有用风险因素的研究结果并不一致。因此,本研究的目的是验证两种不同的姿势描记技术和一种改良的定时起立行走测试(TUG),以区分帕金森病患者中的跌倒者和非跌倒者。
对32名被诊断为特发性帕金森病的患者进行了评估:头晕残障量表、特定活动平衡信心量表、改良TUG、感觉组织测试(SOT)和计算机动态姿势描记法的稳定性极限(LOS)、使用Vertiguard设备进行的自由场身体摆动分析结果以及跌倒次数。
跌倒者完成改良TUG的时间更长,步数更多。平均而言,跌倒者在SOT和LOS测试中的表现明显更差,Vertiguard设备显示跌倒风险更高。根据受试者工作特征分析曲线下面积,LOS方向控制和改良TUG中步数的总体准确率接近0.9(高精度)。此外,与SOT参数相比,使用Vertiguard设备评估在识别跌倒者方面更有效。
我们的结果表明,LOS、移动姿势描记法(Vertiguard)、SOT的前庭输入以及改良TUG中的步数对于识别帕金森病患者中的跌倒者非常有用。