用于姿势控制的附加前庭眼反射视觉冲突任务的初步研究。
Preliminary study on an added vestibular-ocular reflex visual conflict task for postural control.
作者信息
Moran Ryan N, Cochrane Graham
机构信息
Department of Health Science, The University of Alabama, Tuscaloosa Alabama, United States.
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama, United States.
出版信息
J Clin Transl Res. 2020 Apr 16;5(4):155-160. eCollection 2020 May 26.
BACKGROUND
Using the modified-Clinical Test of Sensory Integration and Balance (m-CTSIB), clinicians can assess sensory feedback systems of the visual, vestibular, and somatosensory systems on postural control. However, with growing vestibulo-ocular reflex (VOR) assessment, the addition of a VOR task, for sensory feedback on postural control has yet to be investigated.
AIM
The aim of the study was to examine the preliminary effect of an added VOR visual conflict task during postural control conditions of the m-CTSIB at baseline and re-test reliability.
METHODS
Seventeen healthy college-aged individuals completed a baseline m-CTSIB with an added VOR visual conflict condition consisting of a lateral headshake and follow-up assessment occurring 72-h after baseline. Measures consisted of m-CTSIB sway scores on individual conditions of eyes open and eyes closed tasks on firm and foam surfaces. A series of Wilcoxon matched-pairs signed-rank tests were conducted to determine the differences between the VOR condition and the m-CTSIB conditions. A Spearman Rank Order correlation was used to examine the retest reliability.
RESULTS
The VOR visual conflict task condition produced worse sway index scores than eyes-open firm and foam (p<0.001), but better scores than eyes-closed foam (=0.01) conditions at baseline. VOR tasks on their respective firm (r=0.81) and foam surface (r=0.83) were strongly correlated at 72-h retest.
CONCLUSIONS
The addition of a VOR visual conflict task condition differed from the other conditions of the m-CTSIB, further targeting the vestibular-ocular system from the vestibular-spinal system during postural control. Incorporating a VOR task during postural stability may create greater postural control deficits in individuals with vestibular-ocular dysfunction. Test-retest correlations at 72-h were clinically acceptable.
RELEVANCE FOR PATIENTS
Addition of a VOR task as visual conflict condition of the m-CTSIB may assist in additional sensory system feedback for concussion assessment.
背景
使用改良版感觉统合与平衡临床测试（m-CTSIB），临床医生可以评估视觉、前庭和躯体感觉系统在姿势控制方面的感觉反馈系统。然而，随着前庭眼反射（VOR）评估的不断发展，在姿势控制的感觉反馈中增加VOR任务的情况尚未得到研究。
目的
本研究的目的是在基线和复测信度时，检查在m-CTSIB的姿势控制条件下增加VOR视觉冲突任务的初步效果。
方法
17名健康的大学生完成了基线m-CTSIB，其中增加了由头部横向摆动组成的VOR视觉冲突条件，并在基线后72小时进行随访评估。测量指标包括在睁眼和闭眼任务的个体条件下，在坚实和泡沫表面上的m-CTSIB摆动分数。进行了一系列Wilcoxon配对符号秩检验，以确定VOR条件与m-CTSIB条件之间的差异。使用Spearman等级相关来检查复测信度。
结果
在基线时，VOR视觉冲突任务条件产生的摆动指数分数比睁眼坚实和泡沫条件差（p<0.001），但比闭眼泡沫条件好（p=0.01）。在72小时复测时，VOR任务在各自的坚实（r=0.81）和泡沫表面（r=0.83）上具有很强的相关性。
结论
增加VOR视觉冲突任务条件与m-CTSIB的其他条件不同，在姿势控制过程中进一步从前庭脊髓系统靶向到前庭眼系统。在姿势稳定期间纳入VOR任务可能会在患有前庭眼功能障碍的个体中产生更大的姿势控制缺陷。72小时的重测相关性在临床上是可以接受的。
对患者的意义
增加VOR任务作为m-CTSIB的视觉冲突条件可能有助于为脑震荡评估提供额外的感觉系统反馈。
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