Arora Tarun, Musselman Kristin E, Lanovaz Joel, Oates Alison
College of Medicine, University of Saskatchewan, Saskatoon, Canada.
College of Medicine, University of Saskatchewan, Saskatoon, Canada; Toronto Rehabilitation Institute-University Health Network, Toronto, Canada; Dept. of Physical Therapy, Faculty of Medicine, University of Toronto, Canada; School of Physical Therapy, University of Saskatchewan, Saskatoon, Canada.
Neurosci Lett. 2017 Mar 6;642:91-96. doi: 10.1016/j.neulet.2017.02.001. Epub 2017 Feb 3.
The present study investigated the effect of haptic input via light touch on standing balance of individuals with incomplete spinal cord injury (iSCI). Centre of pressure (COP) measures during standing were assessed in 16 participants with iSCI (13 males; 61.1±19.9years; C1-L4; AIS C and D) and 13 able-bodied (AB) participants (10 males; 59.4±19.7years). The effects of light touch (touch/no touch), vision (eyes open/closed), and group (iSCI/AB) on COP measures were assessed using a two-way mixed design MANOVA. Correlations were examined between changes in COP measures with touch (ΔCOP), and clinical measures of cutaneous pressure and proprioception in the upper (UE) and lower (LE) extremities in participants with iSCI. Significant main effects for touch (p<0.001), vision (p<0.001), and group (p=0.01) for all COP measures were found. There was a significant interaction between vision and group (p=0.01) for a subset of COP measures. With eyes closed, ΔCOP was positively correlated with UE cutaneous pressure sensation and negatively correlated with LE proprioception. Compared with AB adults, individuals with iSCI show a greater increase in postural sway when standing with eyes closed than with eyes open. Individuals with iSCI can use light touch to reduce postural sway, and the effect is greater in those with more intact UE cutaneous pressure sensation and more impaired LE proprioception.
本研究调查了通过轻触进行的触觉输入对不完全性脊髓损伤(iSCI)个体站立平衡的影响。对16名iSCI参与者(13名男性;年龄61.1±19.9岁;损伤节段C1-L4;美国脊髓损伤协会损伤分级C级和D级)和13名健全(AB)参与者(10名男性;年龄59.4±19.7岁)在站立时的压力中心(COP)测量值进行了评估。使用双向混合设计多变量方差分析评估轻触(触摸/不触摸)、视觉(睁眼/闭眼)和组别(iSCI/AB)对COP测量值的影响。对iSCI参与者中COP测量值的变化(ΔCOP)与上肢(UE)和下肢(LE)皮肤压力和本体感觉的临床测量值之间的相关性进行了检验。发现所有COP测量值在触摸(p<0.001)、视觉(p<0.001)和组别(p=0.01)方面均有显著主效应。对于一部分COP测量值,视觉和组别之间存在显著交互作用(p=0.01)。闭眼时,ΔCOP与UE皮肤压力感觉呈正相关,与LE本体感觉呈负相关。与健全成年人相比,iSCI个体闭眼站立时的姿势摆动比睁眼时增加得更多。iSCI个体可以利用轻触来减少姿势摆动,并且对于那些UE皮肤压力感觉更完整且LE本体感觉受损更严重的个体,这种效果更明显。