正常年轻人自动态平衡能力的测量及其影响因素

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.

Test of balance performance of normal adults on dynamic posturography:outcomes and demographic analysis

Objective To investigate the balance performance of normal adults by use of dynamic posturo-graphy and the effect of demographic factors and to calculate the predictive values of various parameters. MethodsThirteen normal adults, 5 male and 8 female, aged 18 to 35 years, were posturographically measured with Biodex Balance System (BBS) in various systemic conditions, and their demographic data were collected for statistical analysis. ResultsThe test-retest reliability on eye-closed and LOS test was good(r=0.87~0.94, P<0.01). The Stability Index (SI), Anterior/Posterior SI (APSI), Medial/Lateral SI (MLSI), as well as their Standard Deviation (SD), were higher when eyes closed than those when visual feedback was used (eyes open) (P<0.01), and increase significantly when the force plate stability drop to level 4 (P<0.01). APSI and its SD were higher than MLSI and its SD, respectively (t=15.838, 12.672, P<0.001). Vision contributed 21.7%, proprioception 25.5% and vestibule maximum 41.7% to postural control in healthy subjects. With the plate stability level decreasing, the elapsed time (LOST) for subjects to shift their center of gravity to all eight randomly highlighted targets increased significantly (P<0.01), but the Direction Control performance (DC) decreased (P<0.05) only when the plate stability drop to level 4. Age and weight of the subjects correlated with most of the parameters (|r|=0.18~0.50, P=0.045~0.000), except SI and MLSI. There also existed strongly positive correlation between Body Mass Index and LOST (r=0.83, P=0.001), and moderately negative correlation between BMI and DC (r=-0.58, P<0.001). But only LOST was negatively correlative with the subjects` height (r=-0.41, P=0.001). The difference between SI on visual feedback at level 8 and the age-normalized predictive value provided by the manufacturer did not exist in male subjects (Z=1.200, P=0.230), but was significant in female subjects (t=3.927, P=0.006). The sex difference existed in SI, APSI, MLSI and LOST (F=11.593, 6.567, 16.364, 27.813, P=0.001, 0.012, 0.000, 0.000, respectively), but not in DC. ConclusionThe decrease of visual and/or proprioceptive information inputs can lead to a decrease of the control of the center of gravity and an increase of the body sway. The BBS is sensitive to show this nature, and thus, may be a useful tool for the quantitative assessment of equilibrium performance.