Norré M E
Department of Otoneurology, University Hospital, Leuven, Belgium.
Ann Otol Rhinol Laryngol. 1995 Jul;104(7):570-3. doi: 10.1177/000348949510400712.
The effect of head extension on the standing position has been studied by analysis of recordings made by static posturography type III (SPGIII), a set of six test of posturography for sensory interaction. The head extension effect in posturography was evaluated by comparing the results of testing with head extension on a stable platform and on foam rubber to testing with a normal head position. In normal subjects head extension increased the postural sway, but there was no more effect on foam rubber than on the stable platform. For patients with peripheral vestibular disorders the head extension effect on the measured postural sway was evaluated by the difference from the normal condition. This difference could be positive, zero, or negative on the stable platform as well as on foam rubber. In both patients and normal subjects, foam rubber had no more effect than the stable platform. The several types of results could be seen in each category of peripheral vestibular disorders. Only minor nuances could be observed: positive differences were more pronounced in benign paroxysmal positional vertigo, whereas negative ones were more obvious in unilateral vestibular deficits. These findings, moreover, deny that head extension in SPGIII should be considered a condition revealing vestibular dysfunction, as has been supposed. As head extension has an influence on the neck proprioceptor as well as on the position of the otoliths, its effect is ambiguous, which makes the interpretation rather difficult. A neck proprioceptive as well as an otolithic explanation appears to have some clinical support.
通过对静态姿势描记术III型（SPGIII）所做记录的分析，研究了头部伸展对站立姿势的影响，SPGIII是一组用于感觉相互作用的姿势描记术六项测试。姿势描记术中的头部伸展效应通过比较在稳定平台和泡沫橡胶上进行头部伸展测试的结果与正常头部位置测试的结果来评估。在正常受试者中，头部伸展增加了姿势摆动，但在泡沫橡胶上的影响并不比在稳定平台上更大。对于患有外周前庭疾病的患者，通过与正常情况的差异来评估头部伸展对测量的姿势摆动的影响。在稳定平台以及泡沫橡胶上，这种差异可能为正、零或负。在患者和正常受试者中，泡沫橡胶的影响都不比稳定平台更大。在外周前庭疾病的每一类中都可以看到几种类型的结果。只能观察到细微的差别：良性阵发性位置性眩晕中阳性差异更明显，而单侧前庭功能缺损中阴性差异更明显。此外，这些发现否认了在SPGIII中头部伸展应被视为一种揭示前庭功能障碍的情况，正如人们所认为的那样。由于头部伸展对颈部本体感受器以及耳石位置都有影响，其效果是不明确的，这使得解释相当困难。颈部本体感受以及耳石的解释似乎有一些临床依据。
