姿势摆动、跌倒和老年女性癌症幸存者的自我报告神经病变。
Postural sway, falls, and self-reported neuropathy in aging female cancer survivors.
机构信息
Department of Neurology, Oregon Health & Science University, United States; Department of Health, Kinesiology, and Recreation, University of Utah, United States.
Department of Neurology, Oregon Health & Science University, United States.
出版信息
Gait Posture. 2019 Mar;69:136-142. doi: 10.1016/j.gaitpost.2019.01.025. Epub 2019 Jan 17.
BACKGROUND
Falls are a major public health concern in older adults, and the proportion of older adults that has been diagnosed with cancer is growing. Yet, while falls, peripheral neuropathy, and postural instability are more common in aging cancer survivors, it is unclear how these factors interact.
RESEARCH QUESTION
Our objective was to examine how components of sway related to self-reported neuropathy and falls.
METHODS
Postural sway during static stance was recorded with an inertial sensor (APDM Opal), placed on the lumbar spine region in 434 older female cancer survivors (mean age 63) and 49 healthy older female control subjects (mean age 63). Measures of sway were resolved into principal components that were compared between women with and women without self-reported falls in the previous 6 months and between those with and without self-reported symptoms of peripheral neuropathy.
RESULTS
Cancer survivors had worse sway than healthy control subjects in components related to sway magnitude and mediolateral frequency of sway, but no difference in the component related to resultant / AP sway jerk and frequency. Cancer survivors who reported neuropathy were more likely to have higher resultant / AP sway frequencies and jerk than asymptomatic survivors, while survivors who reported a fall were more likely to have lower frequencies of mediolateral sway than non-fallers. Falls were more strongly associated with mediolateral sway in survivors with more severe neuropathy; whereas falls were more strongly associated with resultant / AP sway frequency in survivors with less severe neuropathy SIGNIFICANCE: Postural stability, falls, and neuropathy have complex interactions that can vary across components of postural sway. While the frequency of mediolateral sway was associated with falls across our entire cohort, neuropathy influenced the associations between specific characteristics of sway and falls, which may have implications for fall prevention interventions.
背景
跌倒对老年人来说是一个主要的公共健康问题，而被诊断患有癌症的老年人比例正在增加。然而，尽管在衰老的癌症幸存者中，跌倒、周围神经病和姿势不稳更为常见，但这些因素如何相互作用尚不清楚。
研究问题
我们的目的是研究与自我报告的周围神经病和跌倒相关的姿势摆动的组成部分。
方法
在 434 名老年女性癌症幸存者（平均年龄 63 岁）和 49 名健康老年女性对照者（平均年龄 63 岁）的腰椎区域放置惯性传感器（APDM Opal）记录静态站立时的姿势摆动。将摆动的度量分解为主要成分，并在过去 6 个月报告有跌倒和无跌倒的女性之间，以及报告有周围神经病症状和无症状的女性之间进行比较。
结果
与健康对照组相比，癌症幸存者在与摆动幅度和摆动的左右频率相关的摆动成分方面表现出更差的摆动，但在与结果/AP 摆动急动和频率相关的成分方面没有差异。报告周围神经病的癌症幸存者比无症状幸存者更有可能具有更高的结果/AP 摆动频率和急动，而报告跌倒的幸存者比非跌倒者更有可能具有较低的左右摆动频率。在周围神经病较严重的幸存者中，跌倒与左右摆动更密切相关；而在周围神经病较轻的幸存者中，跌倒与结果/AP 摆动频率的相关性更强。
意义
姿势稳定性、跌倒和周围神经病之间存在复杂的相互作用，这种相互作用可能会因姿势摆动的不同成分而有所不同。虽然左右摆动的频率与我们整个队列中的跌倒有关，但周围神经病影响了摆动的特定特征与跌倒之间的关联，这可能对跌倒预防干预措施有影响。
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