Goebel J A, Sataloff R T, Hanson J M, Nashner L M, Hirshout D S, Sokolow C C
Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Otolaryngol Head Neck Surg. 1997 Oct;117(4):293-302. doi: 10.1016/S0194-5998(97)70116-5.
During the last 10 years, computerized dynamic posturography has yielded various patterns of sway on the sensory organization test and the motor control test that have been associated with a variety of organic balance disorders. Some aspects of performance during computerized dynamic posturography, however, are under conscious control. Voluntary movements not indicative of physiologic response to balance system stimulation can also affect computerized dynamic posturography results. Quantification of nonorganic or "aphysiologic" response patterns in normal subjects, patients, and suspected malingerers is crucial to justify use of computerized dynamic posturography for identification of physiologically inconsistent results. For this purpose the computerized dynamic posturography records of 122 normal subjects, 347 patients with known or suspected balance disorders, and 72 subjects instructed to feign a balance disturbance were critically evaluated by use of seven measurement criteria, which were postulated as indicating aphysiologic sway. Each criterion was scored with a standard calculation of the raw data in a random, blinded fashion. The results of this multicenter study show that three of the seven criteria are significantly different in the suspected "malingerer" group when compared with either the normal or patient group. The relative strength of each criterion in discerning organic from nonorganic sway provides the examiner with a measure of reliability during platform posture testing. This study demonstrates that computerized dynamic posturography can accurately identify and document nonorganic sway patterns during routine assessment of posture control.
在过去10年中，计算机化动态姿势描记法在感觉组织测试和运动控制测试中产生了各种摇摆模式，这些模式与多种器质性平衡障碍有关。然而，计算机化动态姿势描记法期间的一些表现方面受意识控制。并非对平衡系统刺激的生理反应的随意运动也会影响计算机化动态姿势描记法的结果。对正常受试者、患者和疑似诈病者的非器质性或“非生理性”反应模式进行量化，对于证明使用计算机化动态姿势描记法来识别生理上不一致的结果至关重要。为此，使用七个测量标准对122名正常受试者、347名已知或疑似平衡障碍患者以及72名被指示假装平衡障碍的受试者的计算机化动态姿势描记法记录进行了严格评估，这七个标准被假定为指示非生理性摇摆。每个标准都以随机、盲法的方式对原始数据进行标准计算来评分。这项多中心研究的结果表明，与正常组或患者组相比，七个标准中的三个在疑似“诈病者”组中有显著差异。每个标准在区分器质性与非器质性摇摆方面的相对强度为检查者在平台姿势测试期间提供了一种可靠性度量。这项研究表明，计算机化动态姿势描记法在姿势控制的常规评估中可以准确识别和记录非器质性摇摆模式。
