颈性眩晕患者的静态平衡和稳定极限特征

doi:10.3969/j.issn.1006-9771.2022.02.005

摘要/Abstract

摘要：

目的分析颈性眩晕患者的静态平衡和稳定极限(LOS)特征。方法 2020年1月至2021年8月,选取本院颈性眩晕患者30例(眩晕组),健康人30例(对照组)。采用PRO-KIN平衡仪进行测试,记录两组在睁眼和闭眼条件下的前后摆动幅度标准差、左右摆动幅度标准差、前后平均运动速度、左右平均运动速度、运动面积、运动长度、8个方向的LOS,计算面积和长度的Romberg值。结果闭眼时,两组各项静态平衡指标数值均大于睁眼时(|Z| > 2.138, P < 0.05);无论睁眼或闭眼,除左右平均运动速度外(|Z| < 1.026, P > 0.05),眩晕组各项静态平衡指标数值均大于对照组(|Z| > 2.004, P < 0.05)。眩晕组在前方(右上方、正上方、左上方)的LOS和总LOS完成百分比均低于对照组(|Z| > 2.240, P < 0.05)。结论颈性眩晕患者静态平衡能力下降,平衡控制有赖于视觉补偿,LOS范围缩小,有较高跌倒风险。

关键词: 颈性眩晕, 静态平衡, 稳定极限

Abstract:

Objective To analyze the characteristics of static balance and limits of stability (LOS) in patients with cervical vertigo (CV). Methods From January, 2020 to August, 2021, 30 CV patients in our hospital (vertigo group) and 30 healthy people (control group) were selected and tested with PRO-KIN system, under the conditions of eyes open and closed. The standard deviation of the vertical and horizontal amplitude, the mean of vertical and horizontal sway velocities, the area of the movement, the length of the movement, and LOS at eight directions, The Romberg ratios of the area and the length were caculated. Results All the indicators of the static balance were higher under eyes closed than under eyes open in both groups (|Z| > 2.138, P < 0.05); whether under the eyes open or closed, the static balance indicators were higher in the vertigo group than in the control group (|Z| > 2.004, P < 0.05), except for the mean of horizontal sway velocities (|Z| < 1.026, P > 0.05). The LOS and total LOS completion percentage in the front (upper right, right above, upper left) were lower in the vertigo group than in the control group (|Z| > 2.240, P < 0.05). Conclusion The static balance abilities decrease for CV patients, and the balance control depends on visual compensation. The range of LOS reduces, means a higher risk of falling.

Key words: cervical vertigo, static balance, limit of stability

中图分类号:

R441.2

罗卫,黄志锐,曹志贤,黄臻,闵瑜,钟陶. 颈性眩晕患者的静态平衡和稳定极限特征[J]. 《中国康复理论与实践》, 2022, 28(2): 165-169.

LUO Wei,HUANG Zhirui,CAO Zhixian,HUANG Zhen,MIN Yu,ZHONG Tao. Static balance and limits of stability in patients with cervical vertigo[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 165-169.

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组别	n	性别(男/女)/n	年龄/岁	体质量/kg	身高/cm
对照组	30	10/20	44.9±9.8	59.4±9.1	163.1±6.7
眩晕组	30	8/22	46.3±10.4	57.5±6.6	160.5±7.1
χ²/t值		0.317	-0.548	0.955	1.455
P值		0.573	0.586	0.344	0.151

组别	n		摆动幅度标准差		平均运动速度/mm•s^-1		运动面积/mm²	运动长度/mm
组别	n		前后方向	左右方向	前后方向	左右方向	运动面积/mm²	运动长度/mm
对照组	30	睁眼	2.0(2.0, 2.3)	1.0(1.0, 2.0)	5.0(4.8, 6.0)	4.0(3.0, 4.0)	59.0(40.8, 84.5)	225.0(185.8, 251.8)
		闭眼	3.0(2.8, 3.0)	2.0(1.0, 2.0)	6.5(6.0, 9.0)	4.0(3.0, 6.0)	89.0(64.5, 136.3)	288.5(253.3, 342.5)
眩晕组	30	睁眼	4.0(4.0, 5.0)	2.0(2.0, 3.0)	6.0(5.0, 7.3)	4.0(3.0, 5.0)	141.5(114.0, 235.0)	240.5(214.3, 326.3)
		闭眼	5.0(4.0, 6.0)	4.0(3.0, 5.0)	9.5(7.0, 14.3)	4.5(3.8, 6.0)	341.0(278.8, 452.3)	346.0(274.5, 504.5)
Z值^a			-3.752	-2.138	-4.351	-3.430	-4.351	-4.546
P值^a			< 0.001	0.033	< 0.001	0.001	< 0.001	< 0.001
Z值^b			-2.775	-4.364	-4.518	-2.334	-4.412	-4.310
P值^b			0.006	< 0.001	< 0.001	0.020	< 0.001	< 0.001
Z值^c			-5.854	-4.007	-2.605	-0.913	-6.092	-2.107
P值^c			< 0.001	< 0.001	0.009	0.361	< 0.001	0.035
Z值^d			-5.817	-5.516	-3.524	-1.026	-6.565	-2.469
P值^d			< 0.001	< 0.001	< 0.001	0.305	< 0.001	0.014

项目		对照组(n = 30)	眩晕组(n = 30)	Z值	P值
LOS值	1-正右方	68.8(62.5, 76.6)	75.7(32.5, 84.4)	-0.207	0.836
	2-右上方	87.95(79.8, 94.8)	54.8(42.0, 85.7)	-3.728	< 0.001
	3-正上方	70.1(66.0, 73.8)	49.4(30.6, 70.0)	-3.247	0.001
	4-左上方	91.9(80.4, 98.1)	74.3(55.3, 93.0)	-2.909	0.004
	5-正左方	72.5(63.8, 78.8)	70.7(49.5, 82.2)	-0.155	0.877
	6-左下方	100.0(95.5, 100.0)	100.0(93.3, 100.0)	-0.229	0.819
	7-正下方	88.8(71.3, 100.0)	97.5(70.0, 100.0)	-0.495	0.621
	8-右下方	100.0(88.0, 100.0)	100.0(90.6, 100.0)	-0.223	0.824
	总LOS	82.3(78.6, 85.7)	77.7(55.0, 86.6)	-2.240	0.025
Romberg值	面积比	163.0(141.8, 205.0)	241.5(161.5, 343.5)	-2.765	0.006
Romberg值	长度比	126.5(113.8, 140.0)	141.5(125.3, 192.3)	-2.004	0.045