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1.
目的量化评估老年人静态平衡功能,及其随年龄变化的特点及规律。方法 60~94岁老年人142例,根据年龄分为7组:60~65岁组、66~70岁组、71~75岁组、76~80岁组、81~85岁组、86~90岁组和90岁以上组,选择18~30岁为健康对照组。采用Tetrax平衡测试系统测定受试者在睁眼自然站立(NO)、闭眼自然站立(NC)、睁眼脚垫站立(PO)、闭眼脚垫站立(PC)4种不同测试状态下的一般稳定性指数(ST)和姿势摆动频谱。结果与对照组比较,老年组ST升高,F1、F4、F6、F8区段摆动强度增加。NO状态:ST、F1、F4、F6、F8在81岁以上各组间有显著性差异(P<0.01);NC状态:ST、F1、F4在81岁以上各组间有显著性差异,F6、F8在66岁以上各组间有显著性差异(P<0.05);PO状态:ST、F4、F6在66岁以上各组间有显著性差异(P<0.05),F1、F8在71岁以上各组间有显著性差异(P<0.05);PC状态:ST、F4在所有老年组间均有显著性差异(P<0.05),F6在66岁以上各组间有显著性差异(P<0.05),F8在76岁以上各组间有显著性差异(P<0.05),而F1在80岁以上老年组有显著性差异(P<0.01)。稳定性指数:NO相似文献   

2.
目的:探讨不同感统训练模式对脑性瘫痪(脑瘫)儿童平衡功能的影响及疗效观察。方法:选取65例合并感统失调的脑瘫患儿随机分为对照组32例和试验组33例。对照组采用一对一的感统训练模式;试验组根据患儿的感统功能障碍类别(感觉调节障碍、感觉辨别障碍、感觉性基础动作障碍)以三人为一组进行小组感统训练。治疗前及治疗3个月后分别采用Tetrax平衡仪测试体重分布系数(weight distribution index,WDI)和Berg平衡量表(Berg balance scale,BBS)进行评估,比较两组患儿平衡功能的疗效差异。结果:①基础姿势,睁眼(basic position,eyes open, NO)、②基础姿势,闭眼(basic position,eyes closed, NC)体位下WDI差异无显著性意义(P0.05),③闭眼,头转向左侧(eyes closed,head turned left,HL)、④闭眼,头向后仰(eyes closed,head raised backwards,HB)、⑤闭眼,低头前倾至胸部(eyes closed,head lowered forwards onto chest,HF)体位下WDI和Berg量表评分差异有显著性意义(P0.05)。结论:小组感统训练可以明显改善年龄4—6岁、GMFCSⅠ—Ⅲ级合并有感统失调的脑瘫患儿在HL、HB、HF 3个体位下的WDI以及Berg评分,其疗效优于一对一训练,这种训练模式值得在临床推广。  相似文献   

3.
目的:探讨相同BMI、身高的老年男性与青年男性站立于硬地和软垫时,前庭、视觉和本体感觉在维持静态平衡中的作用,对提早预防老年男性跌倒提供一定参考依据。方法:使用Biodex平衡仪测试对老年男性43例和在校普通男性大学生40例进行姿势稳定度测试30s、睁眼硬地双脚站立30s、闭眼双脚硬地站立30s、睁眼双脚软垫站立30s、闭眼双脚软垫站立30s及跌倒风险测试。记录不同平衡感觉器官作用下静态平衡能力的变化,并分析前庭、视觉和本体感觉在维持平衡时的作用效果,并分析不同BMI、不同身高和不同年龄段老年人静态平衡能力的特点。结果:①个体在维持平衡的过程中不同平衡感受器作用的差异较大,老年男性与青年男性在不同测试条件中前庭觉作用变化相同,前庭觉在不同年龄段受试者中无明显差异,视觉和本体感觉的退化是引起老年男性平衡能力下降的主要原因。②T1和T2测试中,老年男性的本体感觉占比分别为:30.14%、38.06%,青年男性的本体感觉占比为23.28%、33.83%,老年男性本体感觉占比始终大于青年男性,说明在调节人体平衡过程中,本体感觉对老年男性的作用大于青年男性。③维持人体平衡主要因素是前庭觉,不同测试条件下最低占比58.40%。④老年男性更易发生前后跌倒,跌倒风险随年龄增长具有显著性差异(P0.05)。⑤身高165cm的老年男性表现出更好的平衡能力。老年男性年龄的增长引起视觉的退化会对T3、T4及跌倒风险有较大影响(P0.05)。结论:前庭觉是影响人体平衡能力的重要因素,老年男性与青年男性在不同测试条件中前庭觉作用变化相同,前庭觉在不同年龄段受试者中无明显差异。影响老年男性平衡能力下降的原因为老年男性本体感觉和视觉的下降。老年男性更易发生前后跌倒,且发生可能性随年龄的增长而增加。身高越高的老年男性越容易发生跌倒风险。  相似文献   

4.
目的:为探讨感觉整合模式变化对平衡功能的影响,本研究测量了偏瘫患者治疗前后稳定性及平衡觉三要素的参与比例。方法:符合站立条件的偏瘫患者(54.22±8.63岁)40例,利用Pro-Kine Line 254P动静态平衡仪在训练前后分别记录平板睁眼(T1)、平板闭眼(T2)、海绵睁眼(T3)、海绵闭眼(T4)四种状态下的相关指标,分析视觉、本体觉及前庭觉的变化及对平衡的影响。结果:T1状态时,移动轨迹长(Len=202.88±52.32mm)和平均移动速度(Sv=6.76±1.75mm/s)较训练前更稳定有差异(P0.05),其他指标无差异;T2时,移动轨迹长(Len=10.45±5.66mm)较训练前更稳定有差异(P0.05),其他指标无差异;T3时,移动轨迹长(Len=430.62±159.38mm)、运动椭圆面积(Area=430.59±318.45mm2)、平均移动速度(Sv=14.35±5.31mm/s)较训练前更稳定有差异(P0.05);T4时,站立时间(time=28.07±5.08s)较训练前更长有差异(P0.05),其他指标无差异。训练前视觉、本体觉、前庭觉的参与比例为31.59%、31.39%、61.05%;训练后视觉、本体觉、前庭觉的参与比例为26.11%、34.59%、58.84%。结论:不同阶段的视觉反馈训练可以有效地提高偏瘫患者的平衡能力;训练前视觉代偿对人体维持平衡有重要作用;训练后视觉参与比例下降,本体觉参与比例上升,提示康复训练可以改变平衡感觉整合模式,改善平衡功能,因此可将本体觉与视觉参与比例变化作为监测指标,以指导偏瘫患者康复训练。  相似文献   

5.
目的:研究肥胖成年男性与正常成年男性的膝、踝关节本体感觉能力是否存在差异。方法:共计43例健康成年男性受邀参加此次测试,其中肥胖成年男性27例(BMI 32.6±2.4kg/m~2),正常体重男性16例(BMI 22.9±2.4 kg/m~2);在本研究中,科研人员分别采用自制的踝、膝关节本体感觉能力装置对受试者的踝、膝关节本体感觉能力进行测试。结果:肥胖成年男性表现出膝关节屈(P=0.02)、伸(P=0.04)及踝关节背屈方向(P=0.02)上本体感觉能力的显著下降。结论:肥胖成年男性表现出膝、踝关节本体感觉能力的显著下降,而这会严重削弱其姿势控制能力并导致跌倒及损伤的几率显著增加。  相似文献   

6.
目的:观察本体感觉训练对膝骨性关节炎(KOA)的临床疗效。方法:选取KOA患者102例,随机分为观察组与对照组,每组51例。2组患者均给予常规运动疗法及经皮神经肌肉电刺激治疗,观察组在此基础上进行本体感觉训练。于治疗前、治疗4周后,分别采用角度尺评定关节活动度(ROM);视觉模拟评分法(VAS)进行疼痛评分;BioDex平衡测试系统测量静态跌倒风险指数(SFI)、动态跌倒风险指数(DFI)及姿势稳定极限性(LOS);“起立-行走”计时测试(TUGT)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评价膝关节功能,并于出院3个月后进行满意度评分对远期疗效进行观察。结果:治疗4周后,2组膝关节的主动活动度(AROM)和被动活动度(PROM)、VAS、平衡功能各项评分、TUGT时间、WOMAC评分均显著优于训练前(均P<0.05),且观察组均优于对照组(P<0.05);患者出院3个月后满意度观察组为92.16%,明显高于对照组80.39%(P<0.01)。结论:在常规康复干预基础上联用本体感觉训练能进一步缓解KOA患者疼痛,改善膝关节功能、屈膝角度及平衡能力,提高患者生...  相似文献   

7.
目的探讨感觉系统调节功能障碍对脑卒中后偏瘫患者平衡能力的影响。方法 20例脑卒中偏瘫患者作为实验组,20例正常人为对照组。两组对象分别利用动态姿势平衡仪系统进行感觉组织测试,对受试者的平衡指数和感觉分析指数进行分析。结果实验组的平衡指数在EC、SV、EOSS、ECSS、SVSS5种状态下低于对照组(P<0.05);实验组的本体觉、视觉、前庭觉分数低于对照组(P<0.05),以前庭觉分数降低最明显(P<0.01)。结论脑卒中后患者利用3大感觉信息调节平衡的能力均有不同程度的下降,导致平衡功能障碍。  相似文献   

8.
目的探讨认知双重任务对平衡功能的影响,分析平衡维持的感觉策略。方法 2015年6月至2016年6月,34例健康青年随机分为对照组(n=17)和观察组(n=17),在动态平衡仪上进行改良临床平衡测试。2周后,对照组再次进行测试,观察组在测试时加心算任务。记录站立在硬面和软垫上,睁眼、闭眼状态下的质心摆动速度和质心摆动速度综合值。结果第2次测量时,对照组闭眼软垫站立时,质心摆动速度较第1次降低(t=2.535,P<0.05);观察组睁眼软垫站立时,质心摆动速度较第1次增加(t=-2.220,P<0.05),与对照组相比明显增加(t=-3.128,P<0.01);质心摆动速度综合值对照组较第1次明显降低(t=3.007,P<0.01),观察组较第1次增加(t=-2.170,P<0.05),两组间有显著性差异(t=-2.143,P<0.05)。结论健康青年在加入认知任务后,平衡功能被干扰,特别是睁眼软垫站立时更明显;执行两种或以上任务时,感觉系统优先分配维持平衡。  相似文献   

9.
目的分析老年脑卒中患者平衡功能损害的特征。方法回顾性对照研究。分为患者组和正常对照组。采用Tetrax平衡仪分别检测两组睁眼站立状态下的一般稳定性、体重分布及体重分布指数、跌倒风险指数、同步性及姿势摆动频谱分析。结果 患者组除低频段外,其余频段姿势摆动强度均高于对照组(P<0.05);患者组健侧足跟和足趾部位的体重百分比及体重分布指数均高于对照组(P<0.05);患者组稳定性、"四点"同步性指标(CD、AC、BD、BC)均较对照组差(P<0.05);患者组跌倒风险指数与稳定性、中低频、中高频、高频摆动强度、同侧脚的足跟与足趾以及双脚足跟/足趾对角线同步性(AB、CD、AD、BC)呈正相关(P<0.05),与双侧脚足跟与足趾同步性(AC、BD)呈负相关(P<0.05)。结论老年脑卒中患者平衡功能障碍时身体的稳定性、体重分布及体重分布指数、同步性及姿势摆动频谱均显示异常,跌倒风险与多种因素相关。  相似文献   

10.
目的探索Biodex Balance System(BBS)测试的程序和敏感性,分析个体因素对测试结果的影响,确定参数的预测值. 方法应用BBS对13名正常年轻人(18~35岁)进行不同系统设置条件下的动态姿势图测量和稳定性测试,将测量结果与个体因素进行比较分析. 结果 8级闭眼时及稳定性测试的完成时间(LOST)有较好的重测信度(r=0.87~0.94, P<0.01).稳定指数(SI, APSI, MLSI)及采样标准差(SD, APSD, MLSD)闭眼时高于视觉反馈时(P<0.01),并在平台稳定性减少到4级时明显增大(P<0.01).APSI大于 MLSI(t=15.838, P=0.000),APSD大于MLSD(t=12.672,P=0.000).对姿势控制的贡献率视觉为21.7%,本体感觉为25.3%,前庭感觉最大可达41.7%.LOST随平台稳定性减少而增加,各级别间的差异有非常显著性意义(P<0.01);方向控制能力(DC)在平台稳定性减少到4级时明显减少(P<0.05).年龄和体重与大部分参数有相关性(|r|=0.18~0.50, P=0.045~0.000),与SI、MLSI无相关性;体重指数与LOST高度正相关(r=0.83, P=0.000), 与平均DC中度负相关(r=-0.58,P=0.000),身高与LOST中度负相关 (r=-0.41, P=0.001).男性8级视觉反馈SI(1.520±0.222)与标准化正常值无差异(Z=1.200,P=0.230),女性(1.275±0.191)小于标准化正常值(t=3.927,P=0.006);SI、APSI、MLSI和LOST存在性别差异(F= 6.567~27.813, P=0.012~ 0.000),DC无性别差异. 结论视觉信息和/或本体感觉信息输入的减少会导致躯体摆幅增加和重心控制能力下降,BBS能敏感地反映出这种变化趋势,可用于平衡功能的定量评定.  相似文献   

11.

Objective

To compare the effects of exergaming with conventional weight-shift training on balance function in patients with chronic stroke.

Design

Single-blind randomized controlled trial.

Setting

Medical center.

Participants

Patients (N=30) with chronic stroke and balance deficits.

Interventions

Twelve weeks of Wii Fit training or conventional weight-shift training.

Main Outcome Measures

Static balance was assessed using posturography. We recorded the stability index and percentage of weight bearing on the affected leg in 8 positions. We also used the timed Up and Go and forward reach tests for dynamic balance evaluation, Falls Efficacy Scale-International for fear of falling assessment, and Physical Activity Enjoyment Scale for estimating the enjoyment of training.

Results

The exergaming group showed more improvement in stability index than the control group in head straight with eyes open while standing on a foam surface, eyes closed while standing on a solid surface with head turned 30° to the left, and eyes closed while standing on a solid surface with head turned up positions (time-group interaction P=.02, .04, and .03, respectively); however, the effects were not maintained. At 3-month follow-up, the control group showed more improvement in weight-bearing symmetry in the head straight with eyes open while standing on a solid surface position than the exergaming group (time-group interaction P=.03). Both groups showed improvement in the timed Up and Go test, forward reach test, and fear of falling. The improvement in fear of falling was not maintained. The exergaming group enjoyed training more than the control group (P=.03).

Conclusions

Exergaming is enjoyable and effective for patients with chronic stroke.  相似文献   

12.
BACKGROUND: Fall risk depends on ability to maintain balance during daily activities, and on ability to recover balance following a perturbation such as a slip or trip. We examined whether similar neuromuscular variables govern these two domains of postural stability. METHODS: We conducted experiments with 25 older women (mean age=78 yrs, SD=7 yrs). We acquired measures of postural steadiness during quiet stance (mean amplitude, velocity, and frequency of centre-of-pressure movement when standing with eyes open or closed, on a rigid or compliant surface). We also measured ability to recover balance using the ankle strategy after release from a forward leaning position (based on the maximum release angle where recovery was possible, and corresponding values of reaction time, rate of ankle torque generation, and peak ankle torque). FINDINGS: We found that balance recovery variables were not strongly or consistently correlated with postural steadiness variables. The maximum release angle associated with only three of the sixteen postural steadiness variables (mean frequency in rigid, eyes open condition (r=0.36, P=.041), and mean amplitude (r=0.41, P=.038) and velocity (r=0.49, P=.015) in compliant, eyes closed condition). Reaction time and peak torque did not correlate with any steadiness variables, and rate of torque generation correlated moderately with the mean amplitude and velocity of the centre-of-pressure in the compliant, eyes closed condition (r=0.48-0.60). INTERPRETATION: Our results indicate that postural steadiness during quiet stance is not predictive of ability to recover balance with the ankle strategy. Accordingly, balance assessment and fall prevention programs should individually target these two components of postural stability.  相似文献   

13.
Background and aim: The objective of this study was to assess the effect of thoracolumbosacral orthoses (TLSOs) on antero-posterior (AP) sway, medio-lateral (ML) sway and displacement of the center of pressure (COP) during a longitudinal study in patients with adolescent idiopathic scoliosis (AIS). Methods: Eight females aged between 12 and 14.5 years participated in this study. Evaluations were performed prior to the TLSO intervention as a baseline condition, after 1 month, and after 4 months of orthosis use by assessing balance when standing statically on different surfaces. Results: When standing on both lower limbs on a solid surface there were significant differences in ML sway with the eyes both open and closed, and also in A/P sway but only when standing on a solid surface with the eyes open and also when standing on a foam surface with the eyes closed with TLSO use. When standing on the dominant leg, ML sway significantly improved, but AP sway only improved with a foam base surface with the eyes open. Conclusion: This study demonstrated positive effects of wearing a TLSO in improving quiet standing balance and standing on the dominant lower extremity in subjects with AIS after 4 months of brace use.
  • Implications for Rehabilitation
  • Due to a change in body shape such as that caused by scoliosis, human posture changes and spinal deformities affect the position of the center of support, and thus balance ability may change.

  • AIS subjects have poor standing stability compared to a healthy matched control group.

  • Brace wearing had positive effect in improving quiet standing balance and standing on the dominant lower extremity in subjects with AIS undergoing brace treatment after 4 months of TLSO use.

  相似文献   

14.
BackgroundPostural stability is affected in knee osteoarthritis patients who present with pain but the link to pain sensitization is unclear.MethodsPatients with knee osteoarthritis completed the Knee Injury and Osteoarthritis Outcome Score and pressure pain thresholds were assessed bilaterally at the knee, lower leg and forearm prior to standing quietly (1 min) on a force platform in four conditions: Firm surface with open eyes, firm surface with closed eyes, soft surface with open eyes, and soft surface with closed eyes. Pain intensity during standing was assessed via numerical rating scale. Postural stability was assessed by the range, velocity, and standard deviation of the Center of Pressure (CoP) extracted from the force platform. The means of three repeated measures per standing condition were analysed. High-sensitization and low-sensitization groups were defined based on bilateral pressure pain thresholds from leg and arm.FindingsFifty-six patients were included. Compared with the low-sensitization group, the high-sensitization group demonstrated 1) smaller pressure pain thresholds at the knee (P < 0.05) although the Knee Injury and Osteoarthritis Outcome Score and pain intensity were not significantly different between groups, and 2) smaller range of the CoP in the anterior-posterior direction during the soft surface with closed eyes condition (P < 0.05).InterpretationSmaller CoP range suggest that patients with more widespread pain sensitivity have increased postural stiffness compared with the low-sensitization group. The greater stiffness found in high-sensitization patients under sensory restrictions (closed eyes and reduced proprioception) might relate to restricted integration of sensory information due to widespread pain sensitization.  相似文献   

15.
Objective: To compare the balance ability between normal people and non-specific low back pain (nsLBP) patients and explore the relationship between balance ability and muscle function in nsLBP patients. Method: Ten nsLBP patients as nsLBP group and 10 age and gender-matched healthy control subjects as control group were investigated. Posturography on balance platform and surface electromyography(sEMG) were performed to assess all the subjects′ function of equilibrium and muscle activities of erector spinea(ES), multifidus(MF), abdominal external oblique (EO), hamstring (HS) and maximal gluteus (MG) bilaterally. Result: The nsLBP subjects had greater sway on anterior-posterior direction (Y-speed and Y-extension, P=0.05) on feet-together posture and bigger main axis (P=0.023) on nature standing with eyes closed when compared with controls. The iEMG ratios of right MG in nature standing (eyes closed)/ nature standing (eyes open) and feet-together (eyes open)/nature standing (eyes open) in control group were significant higher than that in nsLBP group (P=0.03 and P=0.013). Conclusion: Balance evaluation combined with sEMG measurement on trank and lower limb muscles provided some quantitative information about functional deficits such as postural control and muscle activities in nsLBP patients. This relationship should be emphasized in prevention and rehabilitation of nsLBP.  相似文献   

16.
OBJECTIVE: We aimed to examine the effect of a physical activity program on postural sway and on the attentional control of postural abilities in elderly frail adults. METHOD: Twelve older adults (age 81.4+/-9 years) institutionalised in a geriatric care institution participated in the physical activity program posture-balance-mobility (PBM) twice a week (1 hour per session) for 12 weeks. We analysed stabilometric data for surface and length of the center of pressure (COP) sway, with eyes open and eyes closed, under single-task and dual-task conditions on a firm floor before and after the training program. During the static postural evaluation and under the dual-task condition, subjects performed an attention-demanding cognitive task, the random number generation task. RESULTS: Only the length of COP sway was more important under the dual-task condition than under the single-task condition (p=0.05). At baseline, cognitive performance was significantly weaker under the dual-task condition (standing) than under the single-task condition (seated), with eyes closed but not eyes open (p<0.05). However, after the training program, the performance of the cognitive task did not significantly differ between the dual-task condition with eyes closed and the single-task condition with eyes closed. CONCLUSION: The training program allowed elderly subjects to improve their ability to perform an attention-demanding cognitive task while standing still, in particular with their eyes closed. Although balance seemed to be less stable under the dual-task condition than under the single-task condition, these results could be interpreted as an improvement of the attentional control of postural stability.  相似文献   

17.
Upright stability in humans has been found to decrease with age, certain diseases, or trauma. We investigated stability of standing in people with below-knee amputations (BKA) and in able-bodied controls. Body sway was evaluated during standing on a set of two Kistler force plates, first with eyes open and then with eyes closed. People with BKA were tested twice--first, one to two days after receiving their prostheses, and second, on completing their prosthetic rehabilitation. The results indicate that both able-bodied people and those with BKA sway more with their eyes closed. However, people with BKA are significantly less stable when they stand with either closed eyes or open eyes. We demonstrated that the differences between the groups studied are due to a proprioceptive deficit as a result of partial limb loss. We also found that there was a gradual process of compensation and adaptation, as some people with BKA sway less at the end of the rehabilitation period.  相似文献   

18.
The aim of this study was to investigate how balance ability according to angle of the knee joint changes in young female adults wearing a knee orthosis. [Methods] This study was conducted with 11 healthy female adults. The subjects used a knee brace that could be set to angles of 0°, 15°, and 30° of knee flexion. The ability to balance was evaluated by balance assessment. A total of four postures were used for measurements: a forward-facing posture with the eyes open on a stable surface (NO), a forward-facing posture with the eyes closed on a stable surface (NC), a forward-facing posture with the eyes open on an unstable surface (PO), and a forward-facing posture with the eyes closed on an unstable surface (PC). [Results] Regarding the weight distribution index and stability index on a stable surface, there was no interaction according to whether there was visual deprivation or not or according to knee flexion angle. Furthermore, the stability index on an unstable surface showed no interaction according to whether there was visual deprivation or not or according to knee flexion angle. But the WDI on a stable surface showed no interaction according to whether there was visual deprivation or not or according to knee flexion angle. [Conclusion] There were significant differences in the knee extension range of motion of normal elderly people and knee osteoarthritis, and the quadriceps femoris played an important role in knee function in individuals with knee osteoarthritis.Key words: Osteoarthritis, Knee orthosis, Balance  相似文献   

19.
Objective.— To investigate by static posturography the occurrence of balance disorder in migraineurs without a history of vertigo during the interictal period.
Background.— The link between migraine and balance disorders has long been known but postural balance in migraineurs without manifest vestibulopathy has been rarely studied.
Methods.— We studied 25 migraineurs and age- and gender-matched controls. With static posturography we measured: (1) postural sway with eyes open or closed on a platform or on foam with 4 different head positions; (2) limits of stability as patients change their center of gravity to reach to 8 different points; (3) tandem walking.
Results.— With eyes open, sway velocity was significantly greater in migraineurs than in controls while standing on a firm surface with head backwards or on a foam surface in all head positions. With eyes closed, sway velocity was significantly greater in migraineurs than in controls only while standing on a foam surface with head backwards or turned sideways.
Migraineurs also had an offset center of gravity alignment in all conditions and their average reaction time and maximal excursions were significantly greater in the limits of stability test. In tandem walking, step width was significantly wider and walk speed was significantly slower in migraineurs.
Conclusion.— Our findings support the notion that there is a slight but significant postural instability in migraineurs and it is of central vestibular origin.  相似文献   

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