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中重度创伤性脑损伤患者的平衡障碍:哪些测量方法适用于评估?

Balance impairment in patients with moderate-to-severe traumatic brain injury: Which measures are appropriate for assessment?

作者信息

Joyce Julie M, Debert Chantel T, Chevignard Mathilde, Sorek Gilad, Katz-Leurer Michal, Gagnon Isabelle, Schneider Kathryn J

机构信息

Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.

出版信息

Front Neurol. 2022 Aug 3;13:906697. doi: 10.3389/fneur.2022.906697. eCollection 2022.


DOI:10.3389/fneur.2022.906697
PMID:35989909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9381921/
Abstract

Left untreated, balance impairment following moderate-to-severe traumatic brain injury (TBI) can be highly debilitating and hinder activities of daily life. To detect impairments, clinicians need appropriate assessment tools. The objective of this study was to evaluate the feasibility and utility of a battery of clinical balance assessments in adults with moderate-to-severe TBI within 6-months of injury. Thirty-seven adults with TBI [Glasgow Coma Scale score ≤ 12 (33 M/4 F) age 18-50 years] participated in balance testing. Assessments included the Balance Error Scoring System (BESS), National Institutes of Health Standing Balance Test (NIH-SBT), Functional Gait Assessment (FGA), Advanced Functional Gait Assessment (FGA-A), Tandem Gait Test (TGT), Berg Balance Scale (BBS), and Walking While Talking Test (WWTT). We identified pronounced ceiling effects on the BBS and FGA, two widely used clinical balance assessments. The NIH-SBT, WWTT, and FGA used in conjunction with the FGA-A, offered versatility in their capacity to assess patients across the balance severity spectrum. This study provides evidence to support a stepwise approach to balance assessment that can be adapted to the broad range of balance ability found in moderate-to-severe TBI.

摘要

如果不进行治疗,中重度创伤性脑损伤(TBI)后的平衡障碍会使人极度虚弱,并妨碍日常生活活动。为了检测这些障碍,临床医生需要合适的评估工具。本研究的目的是评估一系列临床平衡评估方法在损伤后6个月内的中重度TBI成年患者中的可行性和实用性。37名TBI成年患者[格拉斯哥昏迷量表评分≤12(33名男性/4名女性),年龄18 - 50岁]参与了平衡测试。评估包括平衡误差评分系统(BESS)、美国国立卫生研究院站立平衡测试(NIH-SBT)、功能性步态评估(FGA)、高级功能性步态评估(FGA-A)、串联步态测试(TGT)、伯格平衡量表(BBS)和边说话边行走测试(WWTT)。我们发现,在两种广泛使用的临床平衡评估方法BBS和FGA上存在明显的天花板效应。NIH-SBT、WWTT以及与FGA-A联合使用的FGA,在评估不同平衡严重程度的患者时具有多样性。本研究为支持一种逐步进行平衡评估的方法提供了证据,该方法可适用于中重度TBI患者广泛的平衡能力范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f08/9381921/96ed00b43d2e/fneur-13-906697-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f08/9381921/96ed00b43d2e/fneur-13-906697-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f08/9381921/96ed00b43d2e/fneur-13-906697-g0001.jpg

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引用本文的文献

[1]
Characteristics of the Functional Gait Assessment in adolescents with concussion.

Neurosciences (Riyadh). 2023-7

本文引用的文献

[1]
A Lifespan Approach to Balance in Static and Dynamic Conditions: The Effect of Age on Balance Abilities.

Front Neurol. 2022-2-21

[2]
Oculomotor Deficits and Symptom Severity Are Associated With Poorer Dynamic Mobility in Chronic Mild Traumatic Brain Injury.

Front Neurol. 2021-7-26

[3]
Novice vs expert inter-rater reliability of the balance error scoring system in children between the ages of 5 and 14.

Gait Posture. 2021-5

[4]
Tandem gait test performance in healthy, physically active adults: Clinical implications for concussion evaluation.

J Sci Med Sport. 2021-7

[5]
Examining the Relationship Between Conventional Outcomes and Immersive Balance Task Performance in Service Members With Mild Traumatic Brain Injury.

Mil Med. 2021-5-3

[6]
Executive functions, self-awareness and quality of life in chronic moderate-to-severe TBI.

NeuroRehabilitation. 2020

[7]
The Importance and Role of Proprioception in the Elderly: a Short Review.

Mater Sociomed. 2019-9

[8]
Vestibular dysfunction in acute traumatic brain injury.

J Neurol. 2019-6-14

[9]
Single and dual tandem gait assessment post concussion: What performance time is clinically relevant across adult ages and what can influence results?

Musculoskelet Sci Pract. 2019-4-14

[10]
Balance Assessment in Traumatic Brain Injury: A Comparison of the Sensory Organization and Limits of Stability Tests.

J Neurotrauma. 2019-5-6

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