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衰老与平衡表现、前庭功能和躯体感觉阈值之间的关系。

Aging and the Relationship between Balance Performance, Vestibular Function and Somatosensory Thresholds.

机构信息

Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium.

Hasselt University, Faculty of Rehabilitation Sciences, Diepenbeek, Belgium.

出版信息

J Int Adv Otol. 2020 Dec;16(3):328-337. doi: 10.5152/iao.2020.8287.

Abstract

OBJECTIVES

The objective of this study was two-fold: (1) To evaluate the impact of the physiological aging process on somatosensory, vestibular, and balance functions, and (2) To examine the extent to which age and somatosensory and vestibular functions can predict balance performance.

MATERIALS AND METHODS

In this cross-sectional study, 141 asymptomatic subjects were assessed for touch pressure thresholds (TPT) with Semmes-Weinstein monofilaments (SWF), vibration thresholds (VT) with a neurothesiometer (NT) and a Rydel-Seiffer tuning fork 128Hz (RSTF). Horizontal vestibulo-ocular reflexes (HVOR gain and asymmetry) were assessed using the video Head Impulse Test (vHIT). A modified version of the Romberg test was used to assess standing balance and the Timed Up and Go test (TUG) and tandem gait (TG) to evaluate dynamic balance.

RESULTS

Significant age effects were found for TPT, VT, and balance but not for HVOR gain or asymmetry. Standing balance was explained for 47.2% by age, metatarsal 1 (MT1) (NT), and heel (SWF). The variance in TUG performance was explained for 47.0% by age, metatarsal 5 (MT5) (SWF), and medial malleolus (MM) (NT). Finally, the variance in TG performance was predicted for 43.1% by age, MT1 (NT), HVOR gain, and heel (SWF).

CONCLUSION

Among asymptomatic adult population, both somatosensation and balance performance deteriorate with aging. In contrast, HVOR remains rather constant with age, which is possibly explained by the process of vestibular adaptation. Furthermore, this study provides evidence that the VT, TPT, HVOR gain, and age partly predict balance performance. Still, further research is needed, especially with bigger samples in decades 8 and 9.

摘要

目的

本研究旨在(1)评估生理老化过程对躯体感觉、前庭和平衡功能的影响,以及(2)检验年龄以及躯体感觉和前庭功能在多大程度上可以预测平衡表现。

材料与方法

在这项横断面研究中,对 141 名无症状受试者进行了触摸压力阈值(TPT)测试(使用 Semmes-Weinstein 单丝法(SWF))、振动阈值(VT)测试(使用神经感觉计(NT)和 128Hz 的 Rydel-Seiffer 音叉(RSTF))、水平前庭眼反射(HVOR 增益和不对称性)测试(使用视频头脉冲测试(vHIT))。改良的 Romberg 测试用于评估站立平衡,计时起立行走测试(TUG)和 tandem 步态(TG)用于评估动态平衡。

结果

在 TPT、VT 和平衡方面发现了显著的年龄效应,但在 HVOR 增益或不对称性方面没有发现。站立平衡可由年龄、第一跖骨(MT1)(NT)和跟部(SWF)解释 47.2%。TUG 表现的方差可由年龄、第五跖骨(MT5)(SWF)和内踝(NT)解释 47.0%。最后,TG 表现的方差可由年龄、MT1(NT)、HVOR 增益和跟部(SWF)解释 43.1%。

结论

在无症状的成年人群中,躯体感觉和平衡表现均随年龄增长而恶化。相比之下,HVOR 随年龄变化相对稳定,这可能是由于前庭适应过程所致。此外,本研究表明,VT、TPT、HVOR 增益和年龄在一定程度上可以预测平衡表现。但是,仍需要进一步的研究,特别是在 80 岁和 90 岁的人群中增加样本量。

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