Cevette M J, Puetz B, Marion M S, Wertz M L, Muenter M D
Department of Otolaryngology/Head and Neck Surgery/Audiology, Mayo Clinic Scottsdale, AZ 85259, USA.
Otolaryngol Head Neck Surg. 1995 Jun;112(6):676-88. doi: 10.1016/S0194-59989570175-3.
The remarkable ability of the body to maintain balance is the result of central nervous system integration of sophisticated inputs from the vestibular, visual, and somatosensory systems. Strategies by patients with balance dysfunction are aphysiologic when their performance is relatively better on more difficult conditions of sensory conflict than on easier ones. Twenty-two aphysiologic patterns on computerized dynamic posturography were compared with age-matched normal and vestibular patterns. The aphysiologic group performed significantly better than the patients in the vestibular dysfunction group on the most difficult subtests of computerized dynamic posturography, conditions 5 and 6, yet significantly poorer on the easier subtests, conditions 1 through 4. In addition, patients in the aphysiologic group tended to show greater intertrial variability compared with patients in both normal and vestibular system dysfunction groups. A stepwise linear discriminant analysis was used to determine a set of conditions that had significant value in discriminating between the three patient groups. Case studies are presented to further illustrate the clinical usefulness of computerized dynamic posturography testing in the evaluation of patients suspected of having a functional component to their on-feet balance problems.
身体维持平衡的卓越能力是中枢神经系统整合来自前庭、视觉和躯体感觉系统复杂输入的结果。当平衡功能障碍患者在感觉冲突更困难的条件下表现相对优于较容易的条件时，他们的策略是异常的。将计算机化动态姿势描记法上的22种异常模式与年龄匹配的正常模式和前庭模式进行了比较。在计算机化动态姿势描记法最困难的子测试（条件5和6）中，异常组的表现明显优于前庭功能障碍组的患者，但在较容易的子测试（条件1至4）中表现明显较差。此外，与正常组和前庭系统功能障碍组的患者相比，异常组的患者在试验间往往表现出更大的变异性。采用逐步线性判别分析来确定一组在区分这三组患者方面具有显著价值的条件。通过病例研究进一步说明计算机化动态姿势描记法测试在评估疑似存在站立平衡问题功能成分患者中的临床实用性。
