Geurts A C, Ribbers G M, Knoop J A, van Limbeek J
Department of Research and Development, Sint Maartenskliniek, Nijmegen, The Netherlands.
Arch Phys Med Rehabil. 1996 Jul;77(7):639-44. doi: 10.1016/s0003-9993(96)90001-5.
Quantitative evaluation of static and dynamic aspects of postural instability as a long-term consequence of traumatic brain injury (TBI).
Experimental two-group design.
Outpatient rehabilitation department.
From a consecutive sample of TBI patients at least 6 months after trauma, 20 subjects were selected who complained of reduced gross motor skills but showed no sensorimotor impairments in a standard neurological examination (11 men, 9 women; mean age 36.2 +/- 10.7 years). Thirteen patients had sustained mild, 2 moderate, and 5 severe TBI. Twenty healthy controls were matched for age and gender.
None.
A dual-plate force platform recorded the amplitude and velocity of the center-of-pressure fluctuations in the anteroposterior (AP) and lateral (LAT) sway directions during quiet standing. Also, the speed and fluency of weight shifting using visual feedback was registered. Both balance tasks were combined with an arithmetic task, whereas quiet standing was also tested with visual deprivation.
Compared to controls, TBI patients showed an increase of over 50% in AP and LAT sway, and a weight-shifting speed 20% lower. Dual-task interference was never significant. Visual deprivation was most detrimental for the TBI patients, particularly for LAT sway control.
A long-term overall reduction in both static and dynamic control of posture can be present after TBI, even in patients without clear neurological deficits. Force-plate recordings can identify such (latent) balance problems. Visual deprivation during quiet standing appears a simple, sensitive test for postural instability related to sensory integration deficits.
对创伤性脑损伤（TBI）的长期后果——姿势不稳的静态和动态方面进行定量评估。
实验性两组设计。
门诊康复科。
从创伤后至少6个月的TBI患者连续样本中，选取20名主诉粗大运动技能下降但在标准神经学检查中无感觉运动障碍的受试者（11名男性，9名女性；平均年龄36.2±10.7岁）。13例患者为轻度TBI，2例为中度，5例为重度。选取20名年龄和性别匹配的健康对照者。
无。
一个双板测力平台记录安静站立时前后（AP）和侧向（LAT）摆动方向上压力中心波动的幅度和速度。此外，还记录了使用视觉反馈进行体重转移的速度和流畅性。两项平衡任务均与一项算术任务相结合，而安静站立也在视觉剥夺状态下进行测试。
与对照组相比，TBI患者的AP和LAT摆动增加了50%以上，体重转移速度降低了20%。双任务干扰从未显著。视觉剥夺对TBI患者最为不利，尤其是对LAT摆动控制。
TBI后即使在没有明显神经功能缺损的患者中，也可能长期存在姿势静态和动态控制的整体下降。测力平台记录可以识别此类（潜在的）平衡问题。安静站立时的视觉剥夺似乎是一种针对与感觉整合缺陷相关的姿势不稳的简单、敏感的测试。
