Van den Bosch C G, Gilsing M G, Lee S G, Richardson J K, Ashton-Miller J A
Department of Mechanical Engineering and Applied Mechanics, University of Michigan, Ann Arbor 48109-2125, USA.
Arch Phys Med Rehabil. 1995 Sep;76(9):850-6. doi: 10.1016/s0003-9993(95)80551-6.
A servo-controlled foot platform was used to quantify, in upright stance, the thresholds for sensing ankle inversion and eversion movements in seven geriatric patients with peripheral neuropathy (PN) confirmed by nerve conduction studies and seven age- and gender-matched (C) controls with normal nerve conduction function. The PN group had a 4.6-fold larger (p = 0.0026) threshold (mean [SD] 1.37 [1.74]degrees) for perceiving the presence and direction of an ankle rotation at a 75% rate of success (TH75) than did the C group (0.3[0.17]degrees). Inversion acuity was approximately twice that of eversion acuity in both groups. The PN group demonstrated better proprioceptive acuity in unipedal stance than in bipedal stance, whereas no such difference was found in the C group. Semiquantitative clinical tests of PN group proprioception at the ankle performed in the seated position failed to demonstrate significant differences from controls save in one case; however, the results of such tests at the toe were abnormal in all patients. In the geriatric population, PN is associated with deficits in ankle proprioception known theoretically to hamper maintenance of unipedal balance. It is significant that these deficits are associated with a clinically demonstrable loss of position sense at the toe but not the ankle.
使用一个伺服控制的足部平台，对7名经神经传导研究确诊为周围神经病变（PN）的老年患者以及7名年龄和性别匹配、神经传导功能正常的对照者（C组）在直立姿势下感知踝关节内翻和外翻运动的阈值进行量化。PN组在成功率为75%（TH75）时感知踝关节旋转的存在和方向的阈值（平均值[标准差]为1.37[1.74]度）比C组（0.3[0.17]度）大4.6倍（p = 0.0026）。两组内翻敏锐度约为外翻敏锐度的两倍。PN组在单足站立时的本体感觉敏锐度优于双足站立时，而C组未发现这种差异。在坐位对PN组踝关节本体感觉进行的半定量临床测试中，除1例患者外，与对照组相比未显示出显著差异；然而，所有患者脚趾部位的此类测试结果均异常。在老年人群中，PN与踝关节本体感觉缺陷有关，理论上已知这会妨碍单足平衡的维持。值得注意的是，这些缺陷与临床上可证实的脚趾位置感觉丧失有关，而非踝关节位置感觉丧失。
