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持久症状和客观测量平衡表现之间的 OEF/OIF 退伍军人远程轻度创伤性脑损伤。

Persistent Symptoms and Objectively Measured Balance Performance Among OEF/OIF Veterans With Remote Mild Traumatic Brain Injury.

机构信息

Departments of Physical Medicine and Rehabilitation (Drs Hebert, Forster, and Brenner and Mss Stearns-Yoder and Penzenik) and Neurology (Dr Hebert), University of Colorado, Anschutz Medical Campus, Aurora; Marcus Institute for Brain Health, Anschutz Medical Campus, Aurora, Colorado (Drs Hebert and Brenner and Ms Stearns-Yoder); and VHA Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver, Colorado (Drs Hebert, Forster, and Brenner and Mss Stearns-Yoder and Penzenik).

出版信息

J Head Trauma Rehabil. 2018 Nov/Dec;33(6):403-411. doi: 10.1097/HTR.0000000000000385.

Abstract

OBJECTIVE

To investigate linear relationships between dizziness, fatigue, and depression and posttraumatic stress disorder (PTSD) and objectively measured balance performance in Veterans with remote mild traumatic brain injury (mTBI).

SETTING

Academic laboratory; Veterans Affairs Medical Center.

PARTICIPANTS

Thirty Veterans (28 men) who served in Iraq/Afghanistan and whose most recent mTBI was sustained more than 6 months prior to enrollment.

DESIGN

Cross-sectional, observational trial.

MAIN MEASURES

The Computerized Dynamic Posturography-Sensory Organization Test (CDP-SOT) and the Community Balance and Mobility (CB&M) scale measured balance. Dizziness (Dizziness Handicap Inventory), fatigue (Modified Fatigue Impact Scale), depression-related symptoms (Beck Depression Inventory-II), and PTSD-related symptoms (PTSD Checklist 5) were also measured.

RESULTS

Objectively measured balance, CDP-SOT composite, was impaired (mean score of 67.9). CDP-SOT scores correlated with dizziness (r = -0.53; P = .002), fatigue (r = -0.38; P = .03), depression (r = -0.55; P = .001), and PTSD symptoms (r = -0.53; P = .002). Dizziness, time since most recent mTBI, and PTSD symptoms and depression combined explained significant variability in CDP-SOT scores (R = 0.46; P = .003), as did fatigue depression and PTSD symptoms (R = 0.33; P = .01).

CONCLUSIONS

Impaired balance was identified among the cohort. Findings suggest that dizziness, fatigue, depression and PTSD, and time since most recent mTBI may influence balance performance. Additional research is needed to identify the potentially interrelated natural histories of these co-occurring symptoms.

摘要

目的

调查在患有远程轻度创伤性脑损伤 (mTBI) 的退伍军人中,头晕、疲劳和抑郁与创伤后应激障碍 (PTSD) 之间的线性关系,以及与客观测量的平衡表现之间的线性关系。

地点

学术实验室;退伍军人事务医疗中心。

参与者

30 名曾在伊拉克/阿富汗服役的退伍军人(28 名男性),他们最近的 mTBI 在入组前超过 6 个月。

设计

横断面、观察性试验。

主要措施

计算机动态姿势图-感觉组织测试 (CDP-SOT) 和社区平衡和移动性 (CB&M) 量表测量平衡。还测量了头晕(头晕障碍清单)、疲劳(改良疲劳影响量表)、与抑郁相关的症状(贝克抑郁量表二)和与 PTSD 相关的症状(PTSD 检查表 5)。

结果

客观测量的平衡,CDP-SOT 综合评分,受损(平均得分 67.9)。CDP-SOT 评分与头晕(r = -0.53;P =.002)、疲劳(r = -0.38;P =.03)、抑郁(r = -0.55;P =.001)和 PTSD 症状(r = -0.53;P =.002)相关。头晕、最近一次 mTBI 后的时间以及 PTSD 症状和抑郁合并解释了 CDP-SOT 评分的显著可变性(R = 0.46;P =.003),疲劳、抑郁和 PTSD 症状也是如此(R = 0.33;P =.01)。

结论

在队列中发现了平衡受损。研究结果表明,头晕、疲劳、抑郁和 PTSD 以及最近一次 mTBI 后的时间可能会影响平衡表现。需要进一步研究以确定这些同时发生的症状的潜在相关自然史。

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