Alessandrini M, Micarelli A, Viziano A, Pavone I, Costantini G, Casali D, Paolizzo F, Saggio G
Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy.
Department of Systems Medicine, Neuroscience Unit, University of Rome Tor Vergata, Italy.
Acta Otorhinolaryngol Ital. 2017 Jun;37(3):231-236. doi: 10.14639/0392-100X-1334.
Since changes in vestibular function may be one cause of disequilibrium, major advances in measuring postural control and sensory integration in vestibular impairments have been achieved by using posturography. However, in order to overcome problems related to this type of technology, body-worn accelerometers (ACC) have been proposed as a portable, low-cost alternative to posturography for measurements of postural sway in a friendly and ecologic environment. Due to the fact that no study to date has shown the experimental validity of ACC-based measures of body sway with respect to posturography for subjects with vestibular deficits, the aim of the present study was: i) to develop and validate a practical tool that can allow clinicians to measure postural sway derangements in an otoneurological setting by ACC, and ii) to provide reliable, sensitive and accurate automatic analysis of sway that could help in discriminating unilateral vestibular failure (UVF) patients. Thus, a group of 13 patients (seven females, 6 males; mean age 48.6 ± 6.4 years) affected for at least 6 months by UVF and 13 matched healthy subjects were instructed to maintain an upright position during a static forceplate-based posturography (FBP) acquisition while wearing a Movit® sensor (by Captiks) with 3-D accelerometers mounted on the posterior trunk near the body centre of mass. Pearson product moment correlation demonstrated a high level of correspondence of four time-domain and three frequency-domain measures extracted by ACC and FBP testing; in addition, t-test demonstrated that two ACC-based time- and frequency-domain parameters were reliable measures in discriminating UVF subjects. These aspects, overall, should further highlight the attention of clinicians and researchers to this kind of sway recording technique in the field of otoneurological disorders by considering the possibility to enrich the amount of quantitative and qualitative information useful for discrimination, diagnosis and treatment of UVF. In conclusion, we believe the present ACC-based measurement of sway offers a patient-friendly, reliable, inexpensive and efficient alternative recording technique that is useful - together with clinical balance and mobility tests - in various circumstances, as well as in outcome studies involving diagnosis, follow-up and rehabilitation of UVF patients.
由于前庭功能变化可能是失衡的原因之一,姿势描记法在测量前庭损伤患者的姿势控制和感觉整合方面取得了重大进展。然而,为了克服与这类技术相关的问题,有人提出使用穿戴式加速度计(ACC)作为姿势描记法的一种便携式、低成本替代方法,以便在友好和生态的环境中测量姿势摆动。由于迄今为止尚无研究表明基于ACC的身体摆动测量方法对于前庭功能缺损受试者相对于姿势描记法的实验有效性,本研究的目的是:i)开发并验证一种实用工具,使临床医生能够在耳神经科环境中通过ACC测量姿势摆动紊乱,ii)提供可靠、灵敏和准确的摆动自动分析,有助于鉴别单侧前庭功能衰竭(UVF)患者。因此,一组13例受UVF影响至少6个月的患者(7名女性,6名男性;平均年龄48.6±6.4岁)和13名匹配的健康受试者被要求在基于静态测力平台的姿势描记法(FBP)采集过程中保持直立姿势,同时佩戴一个Movit®传感器(由Captiks公司生产),该传感器带有安装在靠近身体质心的后躯干上的三维加速度计。Pearson积矩相关性表明,ACC和FBP测试提取的四个时域和三个频域测量值具有高度一致性;此外,t检验表明,两个基于ACC的时域和频域参数是鉴别UVF受试者的可靠指标。总体而言,这些方面应进一步引起临床医生和研究人员对耳神经科疾病领域中这种摆动记录技术的关注,考虑到有可能丰富有助于鉴别、诊断和治疗UVF的定量和定性信息。总之,我们认为目前基于ACC的摆动测量提供了一种患者友好、可靠、廉价且高效的替代记录技术,与临床平衡和移动性测试一起,在各种情况下以及在涉及UVF患者诊断、随访和康复的结果研究中都很有用。