Jacobs Jesse V, Boyd James T, Hogarth Penelope, Horak Fay B
Department of Rehabilitation and Movement Science, University of Vermont, 305 Rowell Building, 106 Carrigan Drive, Burlington, VT, 05405, USA.
Department of Neurological Sciences, University of Vermont, 1 So. Prospect Street, UHC - Arnold 2, Burlington, VT, 05401, USA.
Gait Posture. 2015 Mar;41(3):867-70. doi: 10.1016/j.gaitpost.2015.02.018. Epub 2015 Mar 9.
This study sought to (a) determine the domains of clinical balance impairments associated with Huntington's disease (HD), and (b) evaluate associations between balance test scores and other disease-related impairments. Eighteen subjects with genetically definite HD and 17 age-matched control subjects were evaluated on the Mini-BESTest for their clinical balance impairments as well as the Unified HD Rating Scale (UHDRS) motor and total functional capacity scales, Activity-Specific Balance Confidence (ABC) Scale-short form, Montreal Cognitive Assessment (MoCA), and Symbol Digit Modalities Test (SDMT). Results showed that subjects with HD exhibited significantly lower total Mini-BESTest scores than subjects without HD (mean (95% CI)=76 (64-87)% with HD, 98 (96-99)% without HD; p=0.0011). Mini-BESTest item scores were significantly lower for subjects with HD on one-leg stance, postural responses, standing with eyes closed on foam, and dual-task timed up-and-go. Mini-BESTest scores significantly correlated with UHDRS motor (r(2)=0.68; p=0.00003) and total functional capacity (r(2)=0.75; p=0.000006) scores as well as with scores on the ABC short form (r(2)=0.45; p=0.0024), SDMT (r(2)=0.42; p=0.0036), and MoCA (r(2)=0.23; p=0.046) assessments. This study, therefore, demonstrates that balance impairments associated with HD span domains of anticipatory postural adjustments, postural responses, stance in challenging sensory conditions, and gait. Although preliminary, clinical balance impairment appears to be an efficient proxy evaluation of multiple HD-related factors due to associations with functional capacity, other motor impairments, balance confidence, and cognitive abilities.
(a) 确定与亨廷顿舞蹈症（HD）相关的临床平衡障碍领域；(b) 评估平衡测试分数与其他疾病相关障碍之间的关联。对18名基因确诊的HD患者和17名年龄匹配的对照受试者进行了Mini-BESTest测试，以评估其临床平衡障碍，同时还进行了统一HD评定量表（UHDRS）的运动和总功能能力量表、特定活动平衡信心（ABC）量表简表、蒙特利尔认知评估（MoCA）和符号数字模态测试（SDMT）。结果显示，HD患者的Mini-BESTest总分显著低于非HD患者（HD患者平均（95%置信区间）=76（64 - 87）%，非HD患者为98（96 - 99）%；p = 0.0011）。HD患者在单腿站立、姿势反应、在泡沫上闭眼站立以及双任务定时起立行走等Mini-BESTest项目上的得分显著更低。Mini-BESTest分数与UHDRS运动（r(2)=0.68；p = 0.00003）和总功能能力（r(2)=0.75；p = 0.000006）分数以及ABC简表（r(2)=0.45；p = 0.0024）、SDMT（r(2)=0.42；p = 0.0036）和MoCA（r(2)=0.23；p = 0.046）评估的分数显著相关。因此，本研究表明，与HD相关的平衡障碍涵盖预期姿势调整、姿势反应、在具有挑战性的感觉条件下的站立以及步态等领域。尽管是初步研究，但由于临床平衡障碍与功能能力、其他运动障碍、平衡信心和认知能力相关，它似乎是对多种HD相关因素的有效替代评估。
