Evans M K, Krebs D E
MGH Institute of Health Professions, Boston, MA 02114-4719, USA.
Otolaryngol Head Neck Surg. 1999 Feb;120(2):164-73. doi: 10.1016/S0194-5998(99)70401-8.
The clinical usefulness of posturography is unknown, despite its costing more than +500 per test in some areas of the United States, including Boston. We cross-sectionally and prospectively studied blinded vestibulo-ocular and vestibulospinal tests from 29 stable patients with chronic vestibular hypofunction; 22 patients were affected bilaterally (BVH), and 7 were affected unilaterally (UVH). Vestibulo-ocular function was assessed by electronystagmographic caloric stimulation and sinusoidal vertical axis rotation gains at 0.05 Hz. Vestibulospinal function was assessed by moving-platform and visualsurround posturography sensory organization tests (SOTs), paced and free gait in a gait laboratory, and clinical tests of timed gait and standing. Posturography SOT moving-platform tests 4 through 6, designed to assess vestibular function, correlated significantly (r < or = 0.72, P > or = 0.01) with vestibulo-ocular tests in 5 of 6 comparisons among BVH patients. Posturography SOT results, however, correlated poorly with other vestibulospinal measures: correlations were statistically significant for only 7 of 18 comparisons with clinical balance and gait function (r < or = 0.69, P > or = 0.01) and with 2 of 12 comparisons for gait laboratory dynamic stability measures (r < or = 0.55, P > or = 0.01) among the BVH patients. When both the platform and visual surround moved (SOT 6), however, correlations were statistically significant with static standing clinical measures (r = 0.51 to 0.69, P < 0.01) and with whole-body maximum moment arm during paced gait (r = 0.55, P < 0.01). Posturography scores for the UVH patients did not significantly correlate with any vestibulo-ocular or other vestibulospinal measures. These data indicate that among patients with BVH posturography SOT scores relate at best modestly with accepted measure of vestibulo-ocular function, less well with clinical measures of balance control, and poorly with dynamic gait-performance measures. We conclude that posturography SOT does not assess vestibulospinal function.
姿势描记法的临床实用性尚不清楚，尽管在美国的一些地区，包括波士顿，该检查每次花费超过500美元。我们对29例慢性前庭功能减退的稳定患者进行了横断面和前瞻性研究，对眼前庭和前庭脊髓测试进行了盲法评估；22例患者为双侧受累（BVH），7例为单侧受累（UVH）。通过眼震电图冷热刺激和0.05Hz时的正弦垂直轴旋转增益评估眼前庭功能。通过移动平台和视觉环绕姿势描记法感觉组织测试（SOT）、步态实验室中的定速和自由步态以及定时步态和站立的临床测试评估前庭脊髓功能。姿势描记法SOT移动平台测试4至6旨在评估前庭功能，在BVH患者的6项比较中有5项与眼前庭测试显著相关（r≤0.72，P≥0.01）。然而，姿势描记法SOT结果与其他前庭脊髓测量指标的相关性较差：在BVH患者中，与临床平衡和步态功能的18项比较中只有7项具有统计学意义（r≤0.69，P≥0.01），与步态实验室动态稳定性测量的12项比较中有2项具有统计学意义（r≤0.55，P≥0.01）。然而，当平台和视觉环绕都移动时（SOT 6），与静态站立临床测量指标（r = 0.51至0.69，P < 0.01）以及定速步态期间全身最大力矩臂（r = 0.55，P < 0.01）具有统计学意义的相关性。UVH患者的姿势描记法评分与任何眼前庭或其他前庭脊髓测量指标均无显著相关性。这些数据表明，在BVH患者中，姿势描记法SOT评分与公认的眼前庭功能测量指标充其量只有适度的相关性，与平衡控制的临床测量指标相关性较差，与动态步态表现测量指标相关性也很差。我们得出结论，姿势描记法SOT不能评估前庭脊髓功能。
