外周性眩晕患者的平衡功能研究

Study on the balance function in patients with peripheral vestibular disorders

目的评价外周性眩晕患者的平衡功能并分析视觉、本体觉在平衡维持中的特点,为平衡康复治疗提供基线数据。方法研究对象分两组,正常对照组47例,男性21例、女性26例,平均年龄(36.17±13.27)岁;外周性眩晕患者组45例,男性20例、女性25例,平均年龄(47.89±13.04)岁;分别进行硬平板和泡沫板的睁、闭眼共计6种感觉模式的平衡功能测试。结果①外周性眩晕组前后向和左右向的3种感觉评分与平衡评分均较正常对照组低;②除睁眼硬板条件外其余模式的Romberg商(Romberg Quotient),即静态闭眼时姿势面积与睁眼面积的比值、身体压力中心晃动的包络面积(statokinesigram,SKG),即90%身体晃动轨迹点的椭圆面积、最大晃动幅值等参数均较正常对照组增大;以上差异具有统计学意义。结论外周性眩晕患者平衡功能明显下降,而且涉及视觉和本体觉构成,平衡的康复与维持需借助视觉、本体觉补偿,平衡功能检查可为制定个体化前庭康复提供参考。

OBJECTIVE To evaluate the balance function of patients with peripheral vestibular disorders, to analyze the characteristics of vision and proprioception in postural control, and provide baseline data for balance rehabilitation therapy. METHODS All subjects were divided into two groups. 47 normal individuals, 21 male, 26 female, the average age was （36.17±13.27） years old; 45 patients with peripheral vestibular disorders, 20 male, 25 female, the average age was （47.89±13.04） years old. All were assessed by computerized posturography under six upright stance conditions： including standing on the firm surface and foam with eyes open and closed. RESULTS OThe three sensory scores and equilibrium scores on anteroposterior or lateral were lower in case group with statistics significance. （~Except standing on firm surface with eyes open, the Romberg Quotient was higher and the area of statokinesigram （SKG） , the largest amplitude of the center pressure of body were significantly larger in patients with peripheral vestibular disorders. CONCLUSION The postural stability of patients with peripheral vestibular disorders decreases. It is not only the vestibular function but also vision and proprioception that have defects. So the patients with peripheral vestibular disorders need vision and proprioception compensation which is of importance in the rehabilitation therapy to keep the stability of posture. Posturography test can provide a reference and baseline data for individualized vestibular rehabilitation.