不同厚度海绵垫对健康人直立姿势稳定性的影响  

Postural characteristics of healthy subjects under different thickness of foam

作　　者：孔维佳[1] 刘波[1] 吴青[1] 吴媛媛[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院耳鼻咽喉科,武汉430022

出　　处：《中华耳鼻咽喉头颈外科杂志》2007年第10期721-725,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金(30371525);国家杰出青年基金(39925035);国家科技部"十五"攻关计划(2004BA720A18-02);卫生部临床学科重点项目(2004);教育部高等学校博士学科点专项科研基金(2002173)

摘　　要：目的分析健康人直立于不同厚度海绵垫时姿势特征的变化,探讨本体觉受到不同程度干扰时的姿势平衡改变。方法 30例健康人分别站立于坚硬平板和不同厚度的海绵垫,海绵厚度依次从1到5块,每块厚度4.7 cm。每种站立平面下,均睁眼和闭眼各站立30 s。应用姿势描记仪记录人体直立时足底压力中心(center of pressure,COP)晃动的相关参数,包括总轨迹长、平均速度、单位面积轨迹长、外周面积、实效值面积、矩形面积。结果所有参数在睁眼和闭眼条件下均有随海绵垫厚度的增加而变化趋势(睁眼时 F 值为9.14～107.18,闭眼时 F 值为32.19～144.35,P 值均<0.0001),除单位面积轨迹长呈减少趋势外,其余参数均为增加趋势;对各参数在不同海绵垫间的差异进行比较,无统计学意义的情况有:①总轨迹长和速度:睁眼及闭眼时,4和5块之间;②单位面积轨迹长:睁眼时,0和1、1和3、2和3、3和4、4和5块之间;闭眼时,3和4、3和5、4和5块之间;③外周面积:睁眼时2和3、3和4、4和5块之间;闭眼时,3和4、3和5、4和5块之间;④实效值面积和矩形面积:睁眼时2和3、4和5块之间;闭眼时,3和4、3和5、4和5块之间。其余比较差异均有统计学意义(P<0.05)或极显著统计学意义(P<0.01)。结论在一定范围内,随着海绵垫厚度增加,直立其上的人体本体觉受到的干扰程度加剧,其姿势稳定性逐渐降低;应用海绵垫干扰本体觉同时,姿势描记仪记录的各参数中,COP 晃动的轨迹长度和平均速度是较适宜描述姿势平衡变化的指标;应用海绵垫对直立人体足底本体觉进行干扰时,应考虑海绵厚度对结果的影响,选择适宜的厚度,以提高其临床应用价值。Objective To investigate the effects of different thickness of foam on the postural control of standing in healthy subjects. Methods Thirty healthy adult subjects（ 11 males, 19 females）were taken into examination of computerized posturography measurement under different surface conditions such as the firm surface and 1 to 5 layer foams of medium density with 4.7 cm high respectively in stance of feet together with eye open and eye closed for 30 s. The following time-dominated parameters regarding to the center of pressure （COP） movement were used for the analysis ： whole path length （ WPL）, unit path length （UPL） which means the sway velocity of the COP movement, unit area path length （UAPL） , circumference area （CA）, effective value area （EVA） and rectangle areas （RA）. Results All parameters had the increased tendency when the layer of foam was added with both eye open and closed conditions except the UAPL, which had a decreased tendency. The parameters on different layer of foam were significance （ P 〈 0. 05）except the following conditions： ①WPL and UPL on layer 4 and 5 with eyes opened and eyes closed; ② UAPL on layer 2 and 3, layer 3 and 4, layer 4 and 5 with eyes opened, layer 3 and 4, layer 3 and 5 and layer 4 and 5 with eyes closed, ③CA on layer 2 and 3, layer 3 and 4, layer 4 and 5 with eyes opened, layer 3 and 4, layer 3 and 5, layer 4 and 5 with eyes closed ; ④RA and EVA on layer 2 and 3, layer 4 and 5 with eyes opened, layer 3 and 4, layer 4 and 5, layer 3 and 5 with eyes closed. Conclusions The posturalstability of normal subjects decreased when the foam thickness was added in some extent. It was important that the thickness of foam should be considered for interrupting the proprioception of feet in clinical. The whole path length and average velocity of movement of COP can be considered as the stable and sensitivity parameters in the foam posturography.

关 键 词：平衡 肌肉骨骼系统 本位感觉 运动失调 

分 类 号：R764[医药卫生—耳鼻咽喉科]