不同感觉策略下老年人平衡控制的皮质激活特征

doi:10.3969/j.issn.1006-9771.2024.07.014

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (7): 848-853.doi: 10.3969/j.issn.1006-9771.2024.07.014

不同感觉策略下老年人平衡控制的皮质激活特征

董平¹, 阚超杰¹, 郭川²^,³, 庄任¹, 王庆雷³, 钱雪¹()

1.常州市德安医院，江苏常州市 213004
2.南京医科大学第一附属医院，江苏南京市 210029
3.南京医科大学康复医学院，江苏南京市 210029

收稿日期:2024-02-28 出版日期:2024-07-25 发布日期:2024-08-07
通讯作者: 钱雪(1983-)，女，汉族，江苏镇江市人，主管护师，主要研究方向：老年康复护理，E-mail： qianxuenurse@126.com
作者简介:董平(1993-)，女，汉族，江苏盐城市人，护师，主要研究方向：老年康复护理。
基金资助:
国家重点研发计划项目(2023YFC3603604);常州市卫健委青年人才科技项目(QN202244)

Characteristics of cortical activation in balance control under different sensory strategies in the elderly

DONG Ping¹, KAN Chaojie¹, GUO Chuan²^,³, ZHUANG Ren¹, WANG Qinglei³, QIAN Xue¹()

1. Changzhou De'an Hospital, Changzhou, Jiangsu 213004, China
2. The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
3. The School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China

Received:2024-02-28 Published:2024-07-25 Online:2024-08-07
Contact: QIAN Xue, E-mail： qianxuenurse@126.com
Supported by:
National Key Research and Development Program of China(2023YFC3603604);Changzhou Health Commission Young Talent Science and Technology Project(QN202244)

摘要/Abstract

摘要：

目的探讨老年人在不同感觉策略下的平衡控制能力和大脑皮质激活特征。
方法 2023年1月至5月，在常州市不定向招募健康青年人(对照组，n = 19)和老年人(试验组，n = 20)。两组佩戴功能性近红外光谱帽并在平衡仪上完成3种不同感觉策略下的平衡控制任务。试验A为40 s闭眼稳定平面站立，试验B为40 s睁眼不稳定平面站立，试验C为40 s闭眼不稳定平面站立，试验前后分别进行40 s睁眼稳定平面站立。测量并比较两组的总稳定性指数(OSI)和感兴趣区(ROI)的皮质激活β值，其中ROI包括左侧运动前区(LPMC)、右侧运动前区(RPMC)、左侧感觉运动区(LSMC)、右侧感觉运动区(RSMC)、左侧前额叶区(LPFC)和右侧前额叶区(RPFC)。
结果两组在试验A和试验B中的OSI和各ROI的β值无显著性差异(P > 0.05)。在试验C中，试验组的OSI较低(Z = -2.056, P < 0.05)，两组RSMC (t = 2.623, P_FDR< 0.05)、LPMC (Z = -2.360, P_FDR< 0.05)和LPFC (t = 3.202, P_FDR< 0.05)的β值有显著性差异。
结论在视觉和本体感觉同时受限时，老年人平衡控制能力下降，大脑相关脑区激活增加。

关键词: 老年人, 感觉策略, 平衡, 皮质激活, 功能性近红外光谱

Abstract:

Objective To investigate the balance control abilities and cortical activation characteristics of elderly individuals under different sensory strategies.
Methods From January to May, 2023, 19 healthy young adults and 20 elderly individuals were recruited in Changzhou as control group and experimental group, respectively. Both groups wore functional near-infrared spectroscopy (fNIRS) caps and performed balance control tasks on a balance platform under three different sensory strategies. Test A was 40 seconds of standing on a stable surface with eyes closed, Test B was 40 seconds of standing on an unstable surface with eyes open, and Test C was 40 seconds of standing on an unstable surface with eyes closed. Before and after the tests, both groups performed 40 seconds of standing on a stable surface with eyes open. The overall stability index (OSI) and cortical activation β values of the regions of interest (ROI) were measured and compared between two groups. The ROIs included the left premotor cortex (LPMC), right premotor cortex (RPMC), left sensorimotor cortex (LSMC), right sensorimotor cortex (RSMC), left prefrontal cortex (LPFC) and right prefrontal cortex (RPFC).
Results There was no significant difference in OSI and β values of each ROI in Tests A and B between two groups (P > 0.05). In Test C, there was a lower OSI in the experimental group (Z = -2.056, P < 0.05), and there were significant differences in the β values of RSMC (t = 2.623, P_FDR < 0.05), LPMC (Z = -2.360, P_FDR < 0.05) and LPFC (t = 3.202, P_FDR < 0.05) between two groups.
Conclusion Elderly individuals experience a decline in balance control abilities, accompanied by increased activation in related brain regions, when both vision and proprioception are restricted.

Key words: elderly, sensory strategies, balance, cortical activation, functional near-infrared spectroscopy

中图分类号:

R161.7

董平, 阚超杰, 郭川, 庄任, 王庆雷, 钱雪. 不同感觉策略下老年人平衡控制的皮质激活特征[J]. 《中国康复理论与实践》, 2024, 30(7): 848-853.

DONG Ping, KAN Chaojie, GUO Chuan, ZHUANG Ren, WANG Qinglei, QIAN Xue. Characteristics of cortical activation in balance control under different sensory strategies in the elderly[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 848-853.

图/表 3

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表1

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任务	对照组(n = 19)	试验组(n = 20)	Z值	P值
试验A	0.900(0.700, 1.900)	1.500(1.025, 2.700)	-1.760	0.078
试验B	1.400(0.800, 1.600)	1.300(1.100, 1.900)	-0.986	0.324
试验C	1.600(1.400, 2.200)	2.000(1.650, 4.000)	-2.056	0.040

任务	ROI	对照组(n = 19)	试验组(n = 20)	t值/Z值	P_FDR值
试验A	RSMC	0.016±0.047	0.028±0.050	0.769	0.885
	RPMC	0.015±0.078	0.007±0.039	-0.396	0.885
	RPFC	0.013±0.067	0.001±0.073	-0.146	0.885
	LSMC	0.021±0.062	0.013±0.045	-0.499	0.885
	LPMC	0.015±0.077	0.009±0.045	-0.253	0.885
	LPFC	-0.001±0.069	0.015±0.065	0.779	0.885
试验B	RSMC	0.010(-0.070, 0.066)	0.006(-0.257, 0.486)	-0.393	0.748
	RPMC	-0.005±0.081	0.005±0.005	0.468	0.748
	RPFC	-0.005±0.077	0.008±0.067	0.564	0.748
	LSMC	0.002±0.065	0.009±0.072	0.324	0.748
	LPMC	-0.016±0.075	-0.002±0.050	0.671	0.748
	LPFC	-0.016(-0.070, 0.120)	-0.021(-0.039, 0.075)	-0.365	0.748
试验C	RSMC	-0.016±0.075	0.043±0.066	2.623	0.036
	RPMC	-0.002(-0.051, 0.062)	0.019(0.004, 0.053)	-1.489	0.163
	RPFC	0.021(0.004, 0.039)	0.036(-0.002, 0.092)	-0.618	0.536
	LSMC	0.008±0.077	0.050±0.073	1.815	0.117
	LPMC	-0.002(-0.062, 0.047)	0.036(0.014, 0.075)	-2.360	0.036
	LPFC	-0.002±0.076	0.080±0.083	3.202	0.018

不同感觉策略下老年人平衡控制的皮质激活特征

Characteristics of cortical activation in balance control under different sensory strategies in the elderly

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