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评估人工耳蜗植入前后的步态稳定性。

Assessing Gait Stability before and after Cochlear Implantation.

机构信息

Department of Physiology, Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Poland.

Department of Biomechanics, Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Poland.

出版信息

Biomed Res Int. 2019 Jan 14;2019:2474273. doi: 10.1155/2019/2474273. eCollection 2019.

Abstract

BACKGROUND

It is known that cochlear implantation may alter the inner ear and induce vestibular disorders.

RESEARCH QUESTION

How does cochlear implantation influence gait stability? . An experimental group of twenty-one subjects scheduled for cochlear implantation underwent gait testing twice, on the day before cochlear implantation (BCI) and three months after cochlear implantation (ACI), using a motion capture system. A control group of 30 age-matched healthy individuals were also tested.

RESULTS

In the experimental group, the gait stability ratio (GSR) was found to improve in 17 subjects after implantation, by an average of 6%. Certain other parameters also showed statistically significant improvement between the two experimental group tests: step time (p<0.001), single-support phase walking speed (p<0.05), and center of mass (CoM) (p<0.05). Using the CoM results of the control group, we devised a stability classification system and applied it to the pre- and postimplantation subjects. After implantation, increases were seen in the number of subjects classified in interval II (strong stability) and III (weak stability). The number of subjects in interval I (perfect stability) decreased by 1 and in interval IV (no stability) by 4.

SIGNIFICANCE

(1) Although cochlear implantation intervenes in the vestibular area, we found evidence that gait stability improves in most subjects after the surgery, reducing the risk of falls. (2) We found statistically significant improvements in individual parameters (such as single-support phase time), in GSR, and in CoM. (3) Based on CoM results, we proposed a new rule-of-thumb way of classifying patients into gait stability intervals, for use in rehabilitation planning and monitoring.

摘要

背景

已知人工耳蜗植入可能改变内耳并引起前庭障碍。

研究问题

人工耳蜗植入如何影响步态稳定性?

方法

一个实验组的 21 名计划接受人工耳蜗植入的受试者在植入前一天(BCI)和植入后三个月(ACI)进行了两次步态测试,使用运动捕捉系统。还对 30 名年龄匹配的健康对照组进行了测试。

结果

实验组中,17 名受试者在植入后发现步态稳定性比(GSR)提高,平均提高 6%。其他一些参数在两组实验测试之间也显示出统计学上的显著改善:步时(p<0.001)、单支撑相行走速度(p<0.05)和质心(CoM)(p<0.05)。使用对照组的 CoM 结果,我们设计了一个稳定性分类系统,并将其应用于植入前和植入后的受试者。植入后,II 级(强稳定性)和 III 级(弱稳定性)的受试者数量增加。I 级(完美稳定性)的受试者数量减少 1 个,IV 级(无稳定性)的受试者数量减少 4 个。

意义

(1)尽管人工耳蜗植入干预了前庭区域,但我们发现手术后大多数受试者的步态稳定性有所提高,降低了跌倒的风险。(2)我们发现个体参数(如单支撑相时间)、GSR 和 CoM 都有统计学上的显著改善。(3)基于 CoM 结果,我们提出了一种新的分类规则,将患者分为步态稳定性区间,用于康复计划和监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a06d/6348847/e7968ba4ccc3/BMRI2019-2474273.001.jpg

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