Fino Peter C, Raffegeau Tiphanie E, Parrington Lucy, Peterka Robert J, King Laurie A
University of Utah, Department of Health and Kinesiology, Salt Lake City, UT, USA.
University of Utah, Department of Health and Kinesiology, Salt Lake City, UT, USA.
J Biomech. 2020 Nov 9;112:110045. doi: 10.1016/j.jbiomech.2020.110045. Epub 2020 Sep 17.
Increased postural sway is often observed in people with mild traumatic brain injury (mTBI), but our understanding of how individuals with mTBI control their head during stance is limited. The purpose of this study was to determine if people with mTBI exhibit increased sway at the head compared with healthy controls. People with persisting symptoms after mTBI (n = 59, 41 women) and control participants (n = 63, 38 women) stood quietly for one minute in four conditions: eyes open on a firm surface (EO-firm), eyes closed on a firm surface (EC-firm), eyes open on a foam pad (EO-foam), and eyes closed on foam (EC-foam). Inertial sensors at the head, sternum, and lumbar region collected tri-axial accelerations. Root-mean-square (RMS) accelerations in anteroposterior (AP) and mediolateral (ML) directions and sway ratios between the head and sternum, head and lumbar, and sternum and lumbar region were compared between groups. Temporal coupling of anti-phase motion between the upper and lower body angular accelerations was assessed with magnitude squared coherence and cross-spectral phase angles. People with mTBI demonstrated greater sway than controls across conditions and directions. During foam-surface conditions, the control group, but not the mTBI group, reduced ML sway at their head and trunk relative to their lumbar by increasing the expression of an anti-phase hip strategy within the frontal plane. These results are consistent with suggestions of inflexible or inappropriate postural control in people with mTBI.
轻度创伤性脑损伤（mTBI）患者常出现姿势摆动增加的情况，但我们对mTBI患者在站立时如何控制头部的了解有限。本研究的目的是确定与健康对照组相比，mTBI患者头部的摆动是否增加。mTBI后仍有症状的患者（n = 59，41名女性）和对照组参与者（n = 63，38名女性）在四种条件下安静站立一分钟：在坚硬表面睁眼（EO-坚硬）、在坚硬表面闭眼（EC-坚硬）、在泡沫垫上睁眼（EO-泡沫）和在泡沫上闭眼（EC-泡沫）。头部、胸骨和腰椎区域的惯性传感器收集三轴加速度。比较了两组在前后（AP）和内外侧（ML）方向上的均方根（RMS）加速度以及头部与胸骨、头部与腰椎、胸骨与腰椎区域之间的摆动比率。用上半身和下半身角加速度之间的反相运动的时间耦合，通过幅度平方相干和交叉谱相位角进行评估。在各种条件和方向上，mTBI患者的摆动均大于对照组。在泡沫表面条件下，对照组通过增加额面内反相髋策略的表达，相对于腰椎减少了头部和躯干的ML摆动，而mTBI组则没有。这些结果与mTBI患者姿势控制不灵活或不适当的观点一致。
