Palamar Deniz, Güler Hüseyin, Hancı Murat, Sucuoğlu Hamza, Sanus Galip Zihni, Tüzün Şansın
Department of Physical Medicine and Rehabilitation, İstanbul University, Cerrahpaşa Medical Faculty, İstanbul, Turkey.
Department of Neurosurgery, İstanbul University, Cerrahpaşa Medical Faculty, İstanbul, Turkey.
Turk J Phys Med Rehabil. 2018 Mar 11;65(1):74-79. doi: 10.5606/tftrd.2019.2003. eCollection 2019 Mar.
We aimed to evaluate balance using the Tetrax Interactive Balance System (TIBS) in patients with Chiari type I malformation (CM-I) and to assess their fall risk with other clinical parameters.
This cross-sectional, prospective study was conducted at physical medicine and rehabilitation outpatient clinics and neurosurgery department of a university hospital between December 2013 and December 2014. The study included a total of 36 patients (31 females, 5 males; mean age 40.6±10.0 years; range, 18 to 60 years) with CM-I. Dynamic balance was assessed using the Berg Balance Scale (BBS), and posturographic examinations were performed using the TIBS.
The mean Fall Risk Index (FI) value was 42.4±29.8 and the mean BBS score was 55.5±1.5. The most common complaints were neck pain (94.4%), headache (88.9%), paresthesia (86.1%), fatigue (83.3%), and vertigo (80.6%). The mean tonsillar herniation below the foramen magnum was 8.7±3.8 (mm). Of the patients, 15 (42.85%) had syringomyelia. The degree of tonsillar ectopia was statistically significantly lower in patients with syringomyelia (p<0.05). The BBS scores were near identical among the patients with or without syringomyelia, although the FI values were lower in the patients with syringomyelia. Comparing cerebellar ectopia ≤9 mm versus >10 mm, the FI values were slightly higher in the patients with ectopia >10 mm, although there was no statistically significant difference in the FI or BBS values.
Our study results suggest that CM-I can decrease the body balance stability and, thus, increase the fall risk. Evaluation of balance in patients with CM using TIBS static posturography is a simple and effective technique.
我们旨在使用Tetrax交互式平衡系统(TIBS)评估I型Chiari畸形(CM-I)患者的平衡能力,并通过其他临床参数评估其跌倒风险。
这项横断面前瞻性研究于2013年12月至2014年12月在一所大学医院的物理医学与康复门诊及神经外科进行。该研究共纳入36例CM-I患者(31例女性,5例男性;平均年龄40.6±10.0岁;范围18至60岁)。使用Berg平衡量表(BBS)评估动态平衡,并使用TIBS进行姿势描记检查。
平均跌倒风险指数(FI)值为42.4±29.8,平均BBS评分为55.5±1.5。最常见的症状是颈部疼痛(94.4%)、头痛(88.9%)、感觉异常(86.1%)、疲劳(83.3%)和眩晕(80.6%)。枕骨大孔下方扁桃体疝的平均程度为8.7±3.8(mm)。其中15例(42.85%)患者患有脊髓空洞症。脊髓空洞症患者的扁桃体异位程度在统计学上显著较低(p<0.05)。有或无脊髓空洞症的患者BBS评分几乎相同,尽管脊髓空洞症患者的FI值较低。比较小脑异位≤9mm与>10mm的患者,异位>10mm的患者FI值略高,尽管FI或BBS值无统计学显著差异。
我们的研究结果表明,CM-I可降低身体平衡稳定性,从而增加跌倒风险。使用TIBS静态姿势描记法评估CM患者的平衡是一种简单有效的技术。