脑卒中偏瘫患者静态和动态平衡评定的研究

Assessment of static and dynamic balance in hemiparetic stroke patients

目的探讨脑卒中偏瘫患者实验室定量测定的静态平衡与临床评定的动态平衡之间的相互关系 ,并探讨两者在脑卒中偏瘫患者功能结局评定中的价值。方法对 19例患者用重心摆动测定法评定静态平衡 ;用Berg平衡量表 (BBS)和起立 行走计时测试 (TUGT)评定动态平衡 ;用功能独立性测量 (FIM )和 10m最大步行速度评测 (MWS)来评定功能结局。用Pearson相关分析法确定静态平衡与动态平衡之间的关系 ,确定静态和动态平衡评定与功能结局之间的关系。结果重心摆动测定参数与BBS之间呈中度负相关 (r =-0 70 5 --0 475 ,P <0 0 5 ) ;闭眼重心摆动测定参数与TUGT之间呈中度的正相关 (r =0 5 0 8-0 5 83 ,P <0 0 5 )。重心摆动测定参数与FIM A和MWS之间无相关性 (r =-0 0 48--0 2 96;r =-0 40 4--0 0 1,P >0 0 5 ) ,BBS与FIM A和MWS之间呈高度的正相关 (r =0 75 2 ;r =0 70 0 ,P <0 0 0 1) ,TUGT与FIM A和MWS之间呈高度的负相关 (r =-0 60 0 ,P<0 0 1;r =-0 817,P <0 0 0 1)。结论在实验室中测定的静态平衡结果与在临床上评定的动态平衡结果是相关联的 ,但是动态平衡评定比静态平衡评定更能有效地反映脑卒中患者的功能结局。

ObjectiveTo discusse the relationship between static balance in laboratory approaches and dynamic balance in clinical assessment and identify the value of static and dynamic balance at functional outcome in hemiparetic stroke patients. MethodsNineteen stroke subjects were assessed in this study. The static balance was measured by postural sway test, the dynamic balance was measured by Berg balance scale(BBS)and Time up to go test(TUGT),the outcome was measured by FIM and 10m maximum walking speed(MWS). The level of association between the parameters of postural sway test and clinical variables were examined with Pearson's correlation coefficients. ResultsThe parameters of postural sway test was significantly negative related to BBS( r =-0.705--0.475, P <0.05);The parameters of postural sway close-eye test was significantly positive related to TUGT( r =0.508-0.583, P <0.05);The parameters of postural sway test was no related to FIM and MWS ( r =-0.048--0.296; r =-0.404--0.01, P >0.05);BBS was significantly positive related to FIM and MWS( r =0.752; r =0.700, P <0.001). TUGT was significantly negative related to FIM and MWS( r =-0.600, P <0.01; r =-0.817, P <0.001). ConclusionClinical and laboratory balance assessments are related and that dynamic rather than static balance measures are valid indicators of functional outcome performance in hemiparetic stroke patients.