Garg Hina, Schubert Michael C, Gappmaier Eduard, Sibthorp Jim, Bo Foreman K, Dibble Leland E
Int J MS Care. 2020 May-Jun;22(3):136-142. doi: 10.7224/1537-2073.2018-064. Epub 2019 Oct 16.
Psychometric properties of tests that assess the angular vestibulo-ocular reflex (aVOR) and vestibulospinal reflex function are currently unknown. This study investigated the test-retest reliability and response stability of gaze stabilization, postural sway, and dynamic balance measures in persons with multiple sclerosis (MS) and controls.
Nineteen adults with MS and 14 controls performed passive horizontal head impulses, quiet standing, and dynamic balance tests on two separate occasions. Gaze stabilization measures included aVOR gain, number of compensatory saccades (CSs) per head rotation, CS latency, and gaze position error. Postural sway included sway amplitude and total sway path. Dynamic balance measure included the Functional Gait Assessment. Intraclass correlation coefficient, standard error of measurement (SEM, SEM%), and minimal detectable difference at 95% confidence level were calculated.
Test-retest reliability for aVOR gain, CSs per head rotation, and gaze position error was moderate and for each postural sway and dynamic balance measure was good. Low error (SEM, SEM%) for aVOR gain, CS latency, postural sway, and dynamic balance variables and low minimal detectable difference values for aVOR gain and Functional Gait Assessment scores were seen, suggestive of acceptable response stability.
These results support the utility of some of the gaze and postural measures for examination and treatment efficacy purposes in people with MS.
目前尚不清楚评估角前庭眼反射(aVOR)和前庭脊髓反射功能的测试的心理测量特性。本研究调查了多发性硬化症(MS)患者和对照组在凝视稳定、姿势摆动和动态平衡测量方面的重测信度和反应稳定性。
19名成年MS患者和14名对照组在两个不同的时间点进行了被动水平头部冲动、安静站立和动态平衡测试。凝视稳定测量包括aVOR增益、每次头部旋转的代偿性扫视(CS)次数、CS潜伏期和凝视位置误差。姿势摆动包括摆动幅度和总摆动路径。动态平衡测量包括功能性步态评估。计算组内相关系数、测量标准误差(SEM,SEM%)和95%置信水平下的最小可检测差异。
aVOR增益、每次头部旋转的CS次数和凝视位置误差的重测信度中等,每种姿势摆动和动态平衡测量的重测信度良好。aVOR增益、CS潜伏期、姿势摆动和动态平衡变量的误差(SEM,SEM%)较低,aVOR增益和功能性步态评估分数的最小可检测差异值较低,提示反应稳定性可接受。
这些结果支持了一些凝视和姿势测量在MS患者检查和治疗效果评估中的实用性。