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使用计算机化动态姿势描记法评估纤维肌痛女性的平衡缺陷:西班牙的一项横断面研究。

Balance deficiencies in women with fibromyalgia assessed using computerised dynamic posturography: a cross-sectional study in Spain.

作者信息

Pérez-de-Heredia-Torres Marta, Huertas-Hoyas Elisabet, Martínez-Piédrola Rosa, Palacios-Ceña Domingo, Alegre-Ayala Jorge, Santamaría-Vázquez Montserrat, Fernández-de-Las-Peñas César

机构信息

Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.

Department of Health Sciences, Burgos Universit, Burgos, Spain.

出版信息

BMJ Open. 2017 Aug 1;7(7):e016239. doi: 10.1136/bmjopen-2017-016239.

Abstract

OBJECTIVES

Our aims were (1) to compare the sensory organisation of balance control and balance strategies between women with fibromyalgia (FM) and healthy women; (2) to investigate which sensory component, that is, vestibular, visual or somato-sensory, is the most affected in FM and (3) to determine the associations between the functional independence measure (FIM) and balance responses in FM.

DESIGN

Cross-sectional observational study.

SETTING

Urban regional hospital and university (Universidad Rey Juan Carlos, Madrid, Spain).

PARTICIPANTS

Twenty women with FM and 20 matched healthy women.

PRIMARY/SECONDARY OUTCOME MEASURES: The sensory organisation test (SOT) was used to determine postural sway and balance during six different conditions with subjects in a standing position. The FIM was used to determine the level of functional independence in daily life activities (ADL). Between-group differences were analysed with analysis of covariance, and the Spearman's test was used for correlations.

RESULTS

Significant differences between-groups and between-conditions were found for all SOT conditions (all, p<0.001): women with FM showed lower scores being the vestibular score the most affected. Different correlations between SOT conditions and some specific ADL were observed in the FM group: bathing activity and balance condition 6 (r=0.541; p<0.001), bed transfers activity and conditions 2 (r=0.491; p<0.001) and 3 (r=0.510; p<0.001), positioning strategy six and dressing the upper (r=0.530; p<0.001) or lower (r=0.562; p<0.001) body, and toileting (r=0.521; p<0.001): the greater the loss of balance, the greater the interference on some daily life activities.

CONCLUSIONS

Women with FM exhibited balance deficiencies and used different strategies for maintaining their balance in standing, which was associated with a negative impact on functional independence.

摘要

目的

我们的目标是:(1)比较纤维肌痛(FM)女性与健康女性在平衡控制和平衡策略方面的感觉组织;(2)研究在FM中受影响最大的感觉成分,即前庭、视觉或躯体感觉;(3)确定FM中功能独立性测量(FIM)与平衡反应之间的关联。

设计

横断面观察性研究。

地点

城市地区医院和大学(西班牙马德里雷胡安·卡洛斯大学)。

参与者

20名FM女性和20名匹配的健康女性。

主要/次要结局指标:感觉组织测试(SOT)用于确定受试者站立位时在六种不同条件下的姿势摆动和平衡。FIM用于确定日常生活活动(ADL)中的功能独立水平。组间差异采用协方差分析,Spearman检验用于相关性分析。

结果

在所有SOT条件下均发现组间和条件间存在显著差异(所有p<0.001):FM女性得分较低,其中前庭得分受影响最大。在FM组中观察到SOT条件与一些特定ADL之间存在不同的相关性:洗澡活动与平衡条件6(r=0.541;p<0.001)、床上转移活动与条件2(r=0.491;p<0.001)和3(r=0.510;p<0.001)、定位策略六与上身(r=0.530;p<0.001)或下身(r=0.562;p<0.001)穿衣以及如厕(r=0.521;p<0.001):平衡丧失越大,对某些日常生活活动的干扰越大。

结论

FM女性表现出平衡缺陷,在站立时采用不同的策略来维持平衡,这对功能独立性有负面影响。

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