Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta - UNISUAM, Rio de Janeiro, Brazil.
Clin Biomech (Bristol). 2022 Jul;97:105711. doi: 10.1016/j.clinbiomech.2022.105711. Epub 2022 Jun 24.
Postural instability with an excessive body sway is a disabling manifestation in spinocerebellar ataxia type 3. Whether the larger body sway reflects distinct movement strategies for postural control remains uncertain. This study compared the control of postural stability of people with spinocerebellar ataxia type 3 with healthy subjects using body sway and movement strategy analyses derived from bi- and three-dimensional posturography.
Twenty-three patients (7 men, 16 women, 47 ± 11 years) and 102 healthy participants (34 men, 68 women; 44 ± 22 years) underwent posturography while standing with eyes open/closed tasks. Postural stability was assessed using elliptical area and average velocity of body sway. Spatial patterns (single-, double-, or multi-centered) were derived from the number of high-density regions in the three-dimensional statokinesigram.
Repeated measures two-way analysis-of-variance showed a vision-by-group interaction effect for area (F = 28.831, P < 0.001, η = 0.037) and velocity (F = 59.367, P < 0.001, η = 0.073); sway area and velocity were higher in spinocerebellar ataxia type 3 and increased under eyes-closed condition, with a higher increase in the spinocerebellar ataxia type 3. A main effect for group (F = 11.702, P < 0.001, η = 0.061) but not vision (F = 2.257, P = 0.136, η = 0.005) was found for the number of high-density regions. Spatial patterns were different between groups under trials with eyes closed (χ = 7.46, P = 0.023) but not open (χ = 2.026, P = 0.363), with a shift from single- to double- or multi-centered spatial patterns.
Compared to healthy subjects, a larger body displacement and velocity in spinocerebellar ataxia type 3, mainly under visual constraints, are not related to the predominance of either ankle or hip movement strategies.
姿势不稳伴身体过度晃动是脊髓小脑性共济失调 3 型的一种致残表现。身体晃动幅度较大是否反映出姿势控制的不同运动策略尚不确定。本研究通过二维和三维动静态描记术获取的身体晃动和运动策略分析，比较了脊髓小脑性共济失调 3 型患者和健康受试者的姿势稳定性控制。
23 例患者（男 7 例，女 16 例，47 ± 11 岁）和 102 例健康受试者（男 34 例，女 68 例；44 ± 22 岁）接受睁眼/闭眼任务下的动静态描记术检查。采用身体晃动的椭圆面积和平均速度评估姿势稳定性。三维动静态描记图中高密度区域的数量可得出空间模式（单中心、双中心或多中心）。
重复测量双向方差分析显示，面积（F=28.831，P＜0.001，η=0.037）和速度（F=59.367，P＜0.001，η=0.073）存在视力-组别交互效应；脊髓小脑性共济失调 3 型患者的面积和速度较大，闭眼时增加，且增加幅度大于健康受试者。组间有主要效应（F=11.702，P＜0.001，η=0.061），但视力无主要效应（F=2.257，P=0.136，η=0.005）。高密度区域的数量在试验中因组别而异（χ=7.46，P=0.023），但不因视力而异（χ=2.026，P=0.363），空间模式由单中心转为双中心或多中心。
与健康受试者相比，脊髓小脑性共济失调 3 型患者的身体位移和速度较大，主要发生在视觉受限的情况下，这与踝关节或髋关节运动策略的主导地位无关。
