Gatev P, Thomas S, Lou J S, Lim M, Hallett M
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1428, USA.
Mov Disord. 1996 Nov;11(6):654-64. doi: 10.1002/mds.870110610.
We studied the effects of altered sensory information on standing balance in 25 patients with cortical cerebellar atrophy (CCA), nine patients with olivoponto-cerebellar atrophy (OPCA), and 10 normal subjects. The total sway path and its components, the anteroposterior (AP) sway path and the lateral sway path, were measured under six conditions: (1) standing on a fixed platform with the eyes open and visual surroundings fixed, (2) standing on a fixed platform with the eyes closed, (3) standing on a fixed platform with the eyes open and visual surroundings AP sway referenced, (4) standing on an AP sway-referenced platform with the eyes open and visual surroundings fixed, (5) standing on an AP sway-referenced platform with the eyes closed, and (6) standing on an AP sway-referenced platform with the eyes open and visual surroundings AP sway referenced. Patients swayed more than normal subjects during normal stance (condition 1), when the visual information was absent (condition 2) or distorted (condition 3), and when the proprioceptive information from the ankles was distorted (condition 4). Patients swayed much more than normal, and most fell, when two sensory modalities were affected under condition 5 (proprioceptive information distorted and visual information absent) and condition 6 (both proprioceptive information and visual information distorted). When the patients' sway was normalized to that of the first condition, however, only their lateral sway was greater than the sway in normal subjects. Unlike in normal subjects, the patients' lateral sway varied with the AP sway to approximately the same degree in each condition for conditions 1-5. Clinical ratings of gait and balance were highly correlated with the sway measures. Quantitative testing of standing balance with altered sensory information has better sensitivity than normal stance testing.
我们研究了感觉信息改变对25例皮质小脑萎缩（CCA）患者、9例橄榄脑桥小脑萎缩（OPCA）患者和10名正常受试者站立平衡的影响。在六种条件下测量了总摆动路径及其组成部分，即前后（AP）摆动路径和侧向摆动路径：（1）站在固定平台上，眼睛睁开且视觉环境固定；（2）站在固定平台上，眼睛闭上；（3）站在固定平台上，眼睛睁开且视觉环境以AP摆动为参考；（4）站在以AP摆动为参考的平台上，眼睛睁开且视觉环境固定；（5）站在以AP摆动为参考的平台上，眼睛闭上；（6）站在以AP摆动为参考的平台上，眼睛睁开且视觉环境以AP摆动为参考。在正常站立姿势（条件1）下，当视觉信息缺失（条件2）或扭曲（条件3）时，以及当来自脚踝的本体感觉信息扭曲时（条件4），患者的摆动比正常受试者更多。在条件5（本体感觉信息扭曲且视觉信息缺失）和条件6（本体感觉信息和视觉信息均扭曲）下，当两种感觉模式受到影响时，患者的摆动比正常情况大得多，且大多数患者跌倒。然而，当将患者的摆动与第一种条件下的摆动进行归一化处理时，只有他们的侧向摆动大于正常受试者的摆动。与正常受试者不同，在条件1 - 5的每种条件下，患者的侧向摆动随AP摆动的变化程度大致相同。步态和平衡的临床评分与摆动测量高度相关。对感觉信息改变时的站立平衡进行定量测试比正常姿势测试具有更高的敏感性。
