Lim Yong-Hyun, Kang Kyunghun, Lee Ho-Won, Kim Ji-Soo, Kim Sung-Hee
Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
Center of Self-Organizing Software-Platform, Kyungpook National University, Daegu, South Korea.
Front Neurol. 2021 Feb 12;12:633393. doi: 10.3389/fneur.2021.633393. eCollection 2021.
Patients with benign paroxysmal positional vertigo (BPPV) experience gait unsteadiness not only during the attacks but also between the spells. This study aimed to measure gait changes in BPPV and determine whether these changes are associated with the involved canal or lesion side. We recruited 33 patients with a diagnosis of unilateral BPPV. Patients with other vestibular or central nervous system disorders were excluded. Gait was assessed using the GAITRite™ system before and after canalith repositioning treatment (CRT). After CRT, improvements were observed in various gait parameters including velocity ( < 0.001), cadence ( < 0.001), functional ambulation profile ( = 0.011), and the coefficient of variation of stride time ( = 0.004). Exploration of the center of pressure (COP) distribution also revealed improved stabilization during locomotion after CRT. The spatiotemporal gait variables did not differ between the patients with horizontal- and posterior-canal BPPV, or between the ipsilesional and contralesional sides before CRT. The gait parameters reflecting velocity and rhythmicity along with stability of COP distribution improved after the resolution of BPPV. Episodic overexcitation of semicircular canal may impair the vestibular information that is integrated with the other reference afferent systems and lead to impaired gait performance.
良性阵发性位置性眩晕（BPPV）患者不仅在发作期间，而且在发作间期都会出现步态不稳。本研究旨在测量BPPV患者的步态变化，并确定这些变化是否与受累半规管或患侧有关。我们招募了33例诊断为单侧BPPV的患者。排除了患有其他前庭或中枢神经系统疾病的患者。在进行半规管结石复位治疗（CRT）前后，使用GAITRite™系统评估步态。CRT后，观察到各种步态参数有所改善，包括速度（<0.001）、步频（<0.001）、功能性步行轮廓（=0.011）和步幅时间变异系数（=0.004）。对压力中心（COP）分布的探究还显示，CRT后运动过程中的稳定性有所提高。在CRT前，水平半规管BPPV患者和后半规管BPPV患者之间，以及患侧和对侧之间的时空步态变量没有差异。BPPV症状缓解后，反映速度和节律性的步态参数以及COP分布的稳定性均有所改善。半规管的发作性过度兴奋可能会损害与其他参考传入系统整合的前庭信息，并导致步态表现受损。
