静态直立时足位对眩晕患者姿势平衡的影响  

Effect of foot orientation on the postural stability in patients with vertigo

作　　者：刘波[1] 孔维佳[1] 冷杨名[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：《中国康复医学杂志》2008年第4期313-316,共4页Chinese Journal of Rehabilitation Medicine

基　　金：卫生部临床学科重点项目(2004);国家自然科学基金(30371525);国家杰出青年基金资助项目(39925035);国家科技部"十五"攻关计划(2004BA720A18-02)

摘　　要：目的:分析不同足位对眩晕患者静态直立时的姿势平衡影响,探讨足位在平衡控制和姿势描记中的作用。方法:眩晕组79例患者和正常组92例健康者进行如下静态直立试验:①标准Romberg试验,双足并拢站立;②双脚分开平行直立试验;③强化Romberg试验(踵趾位站立);④单足直立试验。每种测试条件下分别睁眼和闭眼站立,用秒表记录①—④试验中维持平衡的时间,同时用SPG记录①、②条件下的人体足底压力中心的晃动速度(swayvelocity,SV)。结果:①维持平衡时间:眩晕组采取踵趾位和单足站立时,维持平衡时间较正常组降低,差异均有极显著性意义(P<0.001);②SV:采用标准Romberg位和双脚分开站立,眩晕组和正常组相比,睁眼时两组SV差异无显著性意义(P>0.05)。而闭眼时,两组间差异均有显著性意义(P<0.001);③对于眩晕组和正常组,无论睁眼或闭眼,采用双脚分开站立时,SV较标准Romberg位时降低,差异有极显著性意义(P<0.001);④除眩晕组闭眼踵趾位下计时平衡试验结果与其睁眼时标准Romberg足位下的SV呈负相关性外(r=-0.244,P=0.03),其他计时平衡测试结果与各足位下的SV均未发现有相关性。结论:静态直立时不同足位可影响人体平衡控制能力,踵趾位和单足直立测试是对姿势描记的补充,可结合应用于临床评价眩晕患者的平衡功能。Objective：To investigate the effect of foot orientation on the postural stability in patients with vertigo. Method： Seventy-nine patients with vertigo and 92 healthy adults were enrolled the clinical balance tests include： （1）standard Romberg test; （2）feet apart stance test; （3）tandem stance （TS）; （4）unilateral standing （US） tests with eye open （EO） and eye closed （EC）. The average time that subjects kept balance without falling under different stance conditions were recorded with stopwatch. The body sway velocity（SV） during the test （1） and （2） were also recorded with the static posturography （SPG）. Result：Compared with the healthy subjects, the time of keeping balance under TS and US with EO and EC in patients with vertigo decreased （P〈0.001）. The SV under Romberg test and foot apart stance with EO was no difference between the patients with vertigo and control subjects （P〉0.05）, and the difference was significant in EC condition （P〈0.001）. For both the patients with vertigo and healthy subjects, the SV under foot apart decreased than that under Romberg test in both EO and EC conditions （P〈0.001）. The timed results of tandem stance and unilateral stance and quantitative result as the SV recorded by SPG in Romberg test and foot apart stance did not correlated for both groups except the TSEC and SV in the Romberg test for patients with vertigo （r=-0.244, P=0.03）. Conclusion：The foot orientation can affect the postural stability in both patients with vertigo and healthy subjects. The effect of foot position on the results of SPG should been also considered. The tandem stance test and unilateral stance test can provide the additional information to the SPG for measurement of postural stability in patients with vertigo.

关 键 词：姿势 平衡 足位 前庭疾病 姿势描记仪 

分 类 号：R49[医药卫生—康复医学]