帕金森病和多发性硬化症中系统性干扰导致的平衡丧失模式。
Patterns of balance loss with systematic perturbations in Parkinson's disease and multiple sclerosis.
机构信息
Graduate Program in Physical Therapy, University of California San Francisco/San Francisco State University, San Francisco, CA, USA.
Albany Physical Therapy, Albany, CA, USA.
出版信息
NeuroRehabilitation. 2021;49(4):607-618. doi: 10.3233/NRE-210200.
BACKGROUND
Multiple sclerosis (MS) and Parkinson's disease (PD) may affect balance differently. However, no studies have compared loss of balance (LOB) patterns following multi-directional perturbations.
OBJECTIVE
- determine reliability of LOB ratings following standardized manual perturbations; 2) compare LOB ratings in MS, PD, and healthy control (HC) groups following perturbations at upper/lower torso, in anterior/posterior, right/left, and rotational directions.
METHODS
- reviewers rated videotaped LOB following perturbations applied by 4 clinicians in 6-10 HCs. 2) three groups (64 MS, 42 PD and 32 HC) received perturbations. LOB ratings following perturbations were analyzed using two-factor mixed ANOVAs for magnitude and prevalence.
RESULTS
- LOB ratings showed moderate to good ICC and good to excellent agreement. 2) MS group showed greater magnitude and prevalence of LOB than PD or HC groups (p < .001). All groups showed greater LOB from right/left versus anterior/posterior perturbations (p < .01). PD showed greater LOB from perturbations at upper versus lower torso; MS and HC showed greater LOB from posterior versus anterior perturbations.
CONCLUSIONS
Our reliable rating scale showed differences in patterns of LOB following manual perturbations in MS, PD, and HC. Clinically accessible and reliable assessment of LOB could facilitate targeted perturbation-based interventions and reduce falls in vulnerable populations.
背景
多发性硬化症（MS）和帕金森病（PD）可能对平衡产生不同的影响。然而，尚无研究比较过多向扰动后平衡丧失（LOB）的模式。
目的
1）确定标准化手动扰动后 LOB 评分的可靠性；2）比较 MS、PD 和健康对照组（HC）在躯干上下、前后、左右和旋转方向受扰后 LOB 评分的差异。
方法
1）评审员对 4 名临床医生对 6-10 名 HC 进行的扰动后的 LOB 进行录像评估。2）三组（64 例 MS、42 例 PD 和 32 例 HC）接受扰动。使用两因素混合方差分析对扰动后 LOB 评分的幅度和频率进行分析。
结果
1）LOB 评分的 ICC 为中等到良好，一致性为好到极好。2）MS 组的 LOB 幅度和频率均大于 PD 或 HC 组（p<0.001）。所有组的右侧/左侧扰动的 LOB 均大于前/后扰动（p<0.01）。PD 组的上躯干比下躯干的 LOB 更大；MS 和 HC 组的后向扰动比前向扰动的 LOB 更大。
结论
我们可靠的评分量表显示了 MS、PD 和 HC 在手动扰动后 LOB 模式的差异。临床可及且可靠的 LOB 评估可能有助于针对特定的扰动进行干预，并减少易跌倒人群的跌倒。
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