J Am Podiatr Med Assoc. 2020 May 1;110(3). doi: 10.7547/18-194.
Neuropathologic changes may occur in the nervous system due to long-term substance use, leading to functional disability with altering of balance. We know little about substance-related mechanisms that can cause movement disorders. This study investigated the effects of plantar foot sensation and balance on physical performance as an effect of substance use in detoxified patients.
Twenty-three users of cannabis, volatile agents, or narcotic/stimulant agents alone or in combination for at least 1 year (mean age, 27.6 years) and 20 healthy volunteers (mean age, 24.6 years) were included. Participant evaluations were implemented immediately after the detoxification process with psychiatrist approval. Depression, state-trait anxiety, and fear of movement levels were evaluated with the Beck Depression Inventory, State-Trait Anxiety Inventory, and Tampa Scale for Kinesiophobia, respectively. Plantar foot sensations were evaluated with light touch, two-point discrimination, and vibration examinations. Balance was assessed with balance software and a balance board and force platform. Balance path, balance path distance, and center of pressure were recorded. Physical performance was evaluated with the Timed Up and Go (TUG) test in the final step.
There was a significant difference in two-point discrimination of patients versus controls (P < .05). Significant differences were also found in balance values, particularly in the sagittal direction (P < .05). TUG test results of patients compared with controls showed a negative influence on physical function (P < .05).
Detailed examination should be performed to understand movement disorders in substance users. Herein, substance users had impaired two-point discrimination and sagittal balance reciprocally. Thus, customized physiotherapy approaches to substance users should be considered to improve their movement disorders.
长期物质使用可能导致神经系统的神经病理学变化，导致平衡改变的功能障碍。我们对可能导致运动障碍的物质相关机制知之甚少。本研究调查了足底感觉和平衡对经过戒毒的患者身体表现的影响，以了解物质使用的作用。
纳入了 23 名单独或联合使用大麻、挥发性物质或麻醉/兴奋剂至少 1 年的使用者（平均年龄 27.6 岁）和 20 名健康志愿者（平均年龄 24.6 岁）。参与者评估是在精神病医生批准后立即在戒毒过程后进行的。抑郁、状态-特质焦虑和运动恐惧水平分别用贝克抑郁量表、状态-特质焦虑量表和运动恐惧症量表进行评估。足底感觉用轻触、两点辨别和振动检查进行评估。平衡使用平衡软件和平衡板和力平台进行评估。记录平衡路径、平衡路径距离和中心压力。在最后一步用计时起立行走（TUG）测试评估身体表现。
患者与对照组之间的两点辨别差异有统计学意义（P <.05）。平衡值也有显著差异，特别是在矢状方向（P <.05）。与对照组相比，患者的 TUG 测试结果对身体功能有负面影响（P <.05）。
应该进行详细检查以了解物质使用者的运动障碍。在这里，物质使用者的两点辨别和矢状平衡受损相互影响。因此，应该考虑针对物质使用者的定制物理治疗方法来改善他们的运动障碍。
