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慢性阻塞性肺疾病患者的姿势平衡评估

Postural Balance Evaluation in Patients with Chronic Obstructive Pulmonary Disease.

作者信息

Molouki Ali, Roostayi Mohammad Mohsen, Abedi Mohsen, Fakharian Atefeh, Akbarzadeh Baghban Alireza

机构信息

Physiotherapy Research Center, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Tanaffos. 2020 Dec;19(4):392-400.

PMID:33959178
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8088140/
Abstract

BACKGROUND

The risk of falling in patients with chronic obstructive pulmonary disease (COPD) is higher than healthy people, imposing a great financial burden on patients due to clinical diagnosis and treatment. This study aimed to compare static balance between two groups of healthy people and COPD patients, based on cognitive tasks and vision tests, using linear and non-linear analyses.

MATERIALS AND METHODS

A total of 15 patients with COPD and 14 age- and gender-matched healthy individuals were recruited in this study. Variations in the center of pressure were recorded in both medial-lateral (ML) and anterior-posterior (AP) directions by implementing visual feedback and cognitive tasks, with the subject standing on a force plate. Data related to the center of pressure were analyzed in the AP and ML directions by linear methods (i.e., standard deviation of displacement, standard deviation of maximum velocity, average velocity, and phase plane). Also, the nonlinear method (Lyapunov exponents) was used in both directions.

RESULTS

The cognitive tasks improved the center of pressure variables in both groups. In association with the vision tests, only lack of vision had a significant effect on the patients. The results of the linear analysis in the ML direction were significantly higher in the COPD group as compared to the healthy group; however, the results were not significant in the AP direction. Also, the non-linear analysis showed significant differences between the groups.

CONCLUSION

Use of both linear and non-linear analyses is necessary for evaluating the balance of patients with breathing difficulties. Balance disorders in COPD patients were mostly in the ML direction; therefore, postural deformities might be one of the reasons for balance problems in the AP direction.

摘要

背景

慢性阻塞性肺疾病(COPD)患者跌倒的风险高于健康人,临床诊断和治疗给患者带来了巨大的经济负担。本研究旨在基于认知任务和视力测试,采用线性和非线性分析方法,比较两组健康人和COPD患者的静态平衡能力。

材料与方法

本研究共招募了15例COPD患者和14例年龄及性别匹配的健康个体。让受试者站在测力板上,通过实施视觉反馈和认知任务,记录其在内外侧(ML)和前后方向(AP)上的压力中心变化。采用线性方法(即位移标准差、最大速度标准差、平均速度和相平面)对AP和ML方向上与压力中心相关的数据进行分析。同时,在两个方向上均使用非线性方法(李雅普诺夫指数)。

结果

认知任务改善了两组的压力中心变量。与视力测试相关,只有视力缺失对患者有显著影响。COPD组在ML方向上的线性分析结果显著高于健康组;然而,在AP方向上结果不显著。此外,非线性分析显示两组之间存在显著差异。

结论

评估呼吸困难患者的平衡能力时,线性和非线性分析方法都有必要使用。COPD患者的平衡障碍主要发生在ML方向;因此,姿势畸形可能是AP方向平衡问题的原因之一。