健康人不同姿势站立和步行时姿势图参数的重测信度研究

Reliability of Posturographic Parameters Assessing Standing Ability in Different Positions and Walking Activity in Healthy Participants

目的在脑卒中患者恢复中,维持站立位和坐位的能力对后续日常生活活动能力改善产生一定的影响。目前临床上缺乏对姿势控制能力有效的定量评价方式。本研究评价以骨盆质心为基础的姿势图参数在评价不同姿势站立和适宜速度步行时的可靠性。方法 2018年5月17日至6月3日,纳入79例健康青年人,在智能化下肢助行机器人上分别进行双脚站立、左/右脚站立和10 m适宜速度步行评定。运动结束后由系统自动计算出姿势图参数。测试分两次进行,两次测试间隔1 d。结果在双脚站立姿势图测定中,额状面平均摆幅、矢状面平均摆幅、重心移动轨迹总长度和重心移动总面积的组内相关系数(ICC)>0.70;在左/右脚站立姿势图测定中,左脚站立相所评估参数的ICC>0.70,右脚站立相上述参数的ICC>0.49。在适宜速度10 m步行姿势图测定中,重心移动轨迹总长度和重心移动总面积的ICC>0.75。将受试者不同姿势站立相姿势图进行比较,发现双脚站立较单脚站立更为稳定(P<0.01),优势侧对站立稳定性并无明显影响(P>0.05)。结论以骨盆质心为基础进行姿势图评价能可靠地反映在双脚站立、左/右脚站立和适宜速度步行时的姿势控制,在正常人群中有较好的可重复性。

Objective In the recovery process of stroke patients,the ability of maintaining standing and sitting position might have a great effect on the improvement of activity of daily living.There are few the methods which evaluate quantitatively and effectively the ability of position control ability in clinical practice.The aim of the study is to quantitatively evaluate the reliability of posturographic parameters based on the center of pelvis in different standing positions and walking activity.Methods From May to June,2018,Seventy-nine healthy participants were enrolled.They were evaluated with iReGo,a walking assisstant robot,in three conditions:normal standing position,left/right standing position and walking 10 meters at an appropriate speed.The computer calculated the posturographic parameters automatically.The participants completed their second test one day after the first one.Results During normal standing position,the intra-class correlation coefficients(ICC)of average sway in coronal plane,average sway in sagittal plane,path length,and covered area were more than 0.70.During left standing position,ICC of all the above parameters were more than 0.70.During right standing position,ICC of all the above parameters were more than 0.49.When walking 10 meters at an appropriate speed,ICC of path length and covered area were more than 0.75.Comparing different standing positions,the normal standing position was more stable than the left/right standing position,and there was no difference between the left and the right standing positions.Conclusion Posturographic parameters based on the center of pelvis might be a reliable way to assess the position control ability in different standing positions and walking process.