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

Abstract

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

CLC Number:

R441.2

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.

Figures/Tables 4

References 36

[1]	赵鑫, 李中实. 颈性眩晕的诊断及鉴别诊断[J]. 中日友好医院学报, 2016, 30(2): 109-111.
	ZHAO X, LI Z S. J China-Jpn Friendship Hosp, 2016, 30(2): 109-111.
[2]	TAKAHASHI S. Importance of cervicogenic general dizziness[J]. J Rural Med, 2018, 13(1): 48-56. doi: 10.2185/jrm.2958
[3]	LI H, YU T, CHENG P, et al. Moxibustion for cervical vertigo: a protocol for a systematic review and meta-analysis[J]. Medicine (Baltimore), 2020, 99(31): e21405. doi: 10.1097/MD.0000000000021405
[4]	XIE R, YOU J, LIU L, et al. Acupotomy therapy for cervical vertigo: a protocol for a systematic review and meta-analysis[J]. Medicine (Baltimore), 2020, 99(29): e20662. doi: 10.1097/MD.0000000000020662
[5]	罗恒, 刘汝专, 唐晓菊, 等. 颈性眩晕治疗研究进展[J]. 辽宁中医药大学学报, 2020, 22(2): 175-178.
	LUO H, LIU R Z, TANG X J, et al. Advances in treatment of cervical vertigo[J]. J Liaoning Univ Tradit Chin Med, 2020, 22(2): 175-178.
[6]	HAIN T C. Cervicogenic causes of vertigo[J]. Curr Opin Neurol, 2015, 28(1): 69-73. doi: 10.1097/WCO.0000000000000161
[7]	VÉGH I, HARMAT K, GERLINGER I. [Cervical vertigo: reality or fiction?][J]. [in Hu]. Orv Hetil, 2019, 160(25): 967-972.
[8]	杨艳玲. Pro-kin平衡仪对周围性眩晕平衡功能研究[D]. 兰州:甘肃中医药大学, 2018.
	YANG Y L. A randomized controlled clinical trial of balance function exercise system of Pro-kin in patients with peripheral vertigo[D]. Gansu: Gansu University of Chinese Medicine, 2018.
[9]	李旗, 田福玲, 王凤玲, 等. 枕-项针刺对颈本体感觉性眩晕平衡功能的影响[J]. 中华中医药杂志, 2014, 29(11): 3493-3495.
	LI Q, TIAN F L, WANG F L, et al. Effects of the occiput-nape acupuncture on thebalance function of patients with neck proprioception dizziness[J]. Chin J TCM Pharm, 2014, 29(11): 3493-3495.
[10]	林志诚, 陈阿贞, 江一静, 等. 虚拟现实平衡游戏训练对帕金森病患者平衡功能的效果[J]. 中国康复理论与实践, 2016, 22(9): 1059-1063.
	LIN Z C, CHEN A Z, JIANG Y J, et al. Effects of virtual reality balance game on balance function for Parkinson's disease[J]. Chin J Rehabil Theory Pract, 2016, 22(9): 1059-1063.
[11]	PARK S H, LEE Y S. The diagnostic accuracy of the Berg Balance Scale in predicting falls[J]. West J Nurs Res, 2017, 39(11): 1502-1525. doi: 10.1177/0193945916670894
[12]	RIVOLTA M W, AKTARUZZAMAN M, RIZZO G, et al. Evaluation of the Tinetti score and fall risk assessment via accelerometry-based movement analysis[J]. Artif Intell Med, 2019(95): 38-47.
[13]	高敏, 梁英, 王萍芝, 等. 动静态平衡仪评定踝关节稳定性的信效度研究[J]. 中国康复, 2015, 30(6): 451-454.
	GAO M, LIANG Y, WANG P Z, et al. Validity and reliability balance instrument for chronic ankle instability patients[J]. Chin J Rehabil, 2015, 30(6): 451-454.
[14]	李增春, 陈德玉, 吴德升, 等. 第三届全国颈椎病专题座谈会纪要[J]. 中华外科杂志, 2008, 46(23): 1796-1799.
	LI Z C, CHEN D Y, WU D S, et al. Summary of the Third National Symposium on Cervical Spondylosis[J]. Chin J Surg, 2008, 46(23): 1796-1799.
[15]	中华医学会神经病学分会, 中华神经科杂志编辑委员会. 眩晕诊治专家共识[J]. 中华神经科杂志, 2010, 43(5): 369-374.
	Chinese Society of Neurology, Chinese Editorial of Journal of Neurology. Expert Consensus on Vertigo Diagnosis and Treatment[J]. Chin J Neur, 2010, 43(5): 369-374.
[16]	肖仔仙, 陈谦, 孟殿怀. 脑卒中偏瘫恢复期患者双足间距离对静态站立平衡功能的影响[J]. 康复学报, 2021, 31(3): 241-245, 251.
	XIAO Z X, CHEN Q, MENG D H. Effects of the distance between two feet on static standing balance function in convalescent hemiplegic patients with stroke[J]. J Fujian Univ Tradit Chin Med, 2021, 31(3): 241-245, 251.
[17]	凌康, 夏清, 曹晓光, 等. 腰椎间盘突出症患者静态平衡功能分析[J]. 中国康复理论与实践, 2016, 22(6): 715-718.
	LIN K, XIA Q, CAO X G, et al. Analysis of static balance function in patients with lumbar disc herniation[J]. Chin J Rehabil Theory Pract, 2016, 22(6): 715-718.
[18]	KALRON A. The Romberg ratio in people with multiple sclerosis[J]. Gait Posture, 2017, 54: 209-213. doi: 10.1016/j.gaitpost.2017.03.016
[19]	JOHANSSON J, JAROCKA E, WESTLING G, et al. Predicting incident falls: relationship between postural sway and limits of stability in older adults[J]. Hum Mov Sci, 2019, 66: 117-123. doi: 10.1016/j.humov.2019.04.004
[20]	THOMPSON-HARVEY A, HAIN T C. Symptoms in cervical vertigo[J]. Laryngoscope Investig Otolaryngol, 2018, 4(1): 109-115.
[21]	LIN Q, ZHENG Y, LIAN P, et al. Quantitative static and dynamic assessment of balance control in stroke patients[J]. J Vis Exp, 2020(159): e60884.
[22]	林强, 郑煜欣, 廖婉晨, 等. 脑卒中患者静态平衡的足底压力分析[J]. 中国康复理论与实践, 2021, 27(3): 290-296.
	LIN Q, ZHENG Y X, LIAO W C, et al. Static balance function in stroke patients: a plantar pressure analysis[J]. Chin J Rehabil Theory Pract, 2021, 27(3): 290-296.
[23]	SOLIMAN E S, SHOUSHA T M, ALAYAT M S. The effect of pain severity on postural stability and dynamic limits of stability in chronic low back pain[J]. J Back Musculoskelet Rehabil, 2017, 30(5): 1023-1029. doi: 10.3233/BMR-169588
[24]	HASEGAWA N, MAAS K C, SHAH V V, et al. Functional limits of stability and standing balance in people with Parkinson's disease with and without freezing of gait using wearable sensors[J]. Gait Posture, 2021, 87: 123-129. doi: 10.1016/j.gaitpost.2021.04.023
[25]	杨珺, 彭涛, 魏海棠, 等. 小脑卒中后静态平衡功能和稳定极限范围的临床研究[J]. 中国康复医学杂志, 2018, 33(2): 220-222.
	YANG J, PENG T, WEI H T, et al. Clinical study on static balance function and stable limit range after cerebellar stroke[J]. Chin J Rehabil Med, 2018, 33(2): 220-222.
[26]	TOMITA H, KUNO S, KAWAGUCHI D, et al. Limits of stability and functional base of support while standing in community-dwelling older adults[J]. J Mot Behav, 2021, 53(1): 83-91. doi: 10.1080/00222895.2020.1723484
[27]	LI Y, PENG B. Pathogenesis, diagnosis, and treatment of cervical vertigo[J]. Pain Physician, 2015, 18(4) :E583-E595.
[28]	CAO Z, ZHU C, ZHOU Y, et al. Risk factors related balance disorder for patients with dizziness/vertigo[J]. BMC Neurol, 2021, 21(1): 186. doi: 10.1186/s12883-021-02188-7
[29]	刘汉良, 尤春景, 黄晓琳, 等. 正常年轻人自动态平衡能力的测量及其影响因素[J]. 中华物理医学与康复杂志, 2004, 26(5): 23-27.
	LIU H L, YOU C J, HUANG X L, et al. Test of balance performance of normal adults on dynamic posturography: outcomes and demographic analysis[J]. Chin J Phys Med Rehabil, 2004, 26(5): 23-27.
[30]	张丽, 瓮长水, 王秋华, 等. 前庭感觉、本体感觉及视觉功能对老年人跌倒风险影响的因素分析[J]. 中国康复理论与实践, 2010, 16(1): 16-18.
	ZHANG L, WENG C S, WANG Q H, et al. Effect of vestibular sense, proprioception, and vision on fall risk in elderly[J]. Chin J Rehabil Theory Pract, 2010, 16(1): 16-18.
[31]	ABDELKADER N A, MAHMOUD A Y, FAYAZ N A, et al. Decreased neck proprioception and postural stability after induced cervical flexor muscles fatigue[J]. J Musculoskelet Neuronal Interact, 2020, 20(3): 421-428.
[32]	REDDY R S, MEZIAT-FILHO N, FERREIRA A S, et al. Comparison of neck extensormuscle endurance and cervical proprioception between asymptomatic individuals and patients with chronic neck pain[J]. J Bodyw Mov Ther, 2021(26): 180-186.
[33]	YAHIA A, GHROUBI S, JRIBI S, et al. Chronic neck pain and vertigo: is a true balance disorder present?[J]. Ann Phys Rehabil Med, 2009, 52(7-8): 556-567. doi: 10.1016/j.rehab.2009.07.033
[34]	Harvie D S, Hillier S, Madden V J, et al. Neck pain and proprioception revisited using the Proprioception Incongruence Detection Test[J]. Phys Ther, 2016, 96(5): 671-678. doi: 10.2522/ptj.20150210
[35]	L'HEUREUX-LEBEAU B, GODBOUT A, BERBICHE D, et al. Evaluation of paraclinical tests in the diagnosis of cervicogenic dizziness[J]. Otol Neurotol, 2014, 35(10): 1858-1865. doi: 10.1097/MAO.0000000000000506
[36]	DEVARAJA K. Approach to cervicogenic dizziness:a comprehensive review of its aetiopathology and management[J]. Eur Arch Otorhinolaryngol, 2018, 275(10): 2421-2433. doi: 10.1007/s00405-018-5088-z

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

Static balance and limits of stability in patients with cervical vertigo

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 36

Related Articles 10

Metrics

Comments

Recommended 0

[1]	MENG Fan-yuan,ZHAO Yun-xin,YUAN Yin,CHEN Mo-xian,LIU Wei,BAO Wen-li. Static Stability and Stability Limit for Patients with Scoliosis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(11): 1351-1355.
[2]	SONG Gui-yun;ZHANG Pu;YUN Xiao-ping. Measure Static Balance Function with Active Balancer EAB-100: Reference Values and Clinical Significance [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2015, 21(09): 1069-1073.
[3]	WANG Yin-zhi;GU Dong-yun;DAI Ke-rong. Static Balance Evaluated by Maximum Angle of Center of Mass-Center of Pressure in People of Different Ages [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2015, 21(08): 967-973.
[4]	YIN Lun-hui;AO Xiao-long;SHEN Tong;LIANG Wei-jian;ZENG Li-xian;LI Li;SHEN Ling-yan;WU Ze-yong;XU Wei-dan. . Features of Cervical Vertebra X-ray Examination and Transcranial Doppler in Children with Cervical Vertigo [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2014, 20(8): 780-784.
[5]	SU Guo-dong. Relationship between Sit-to-Stand Velocity and Dynamic or Static Balance in Stroke Patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2013, 19(4): 368-370.
[6]	ZHOU Yu-xin;ZHANG Tong;LIU Hui-lin;et al.. Correlation between Sit-to-Stand Velocity and Dynamic and Static Balance in Stroke Patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2011, 17(4): 352-354.
[7]	NING Yu;QIE Shu-yan;DENG Jia-feng;et al. Effect of Cervical Stability Training on Cervical Vertigo [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2010, 16(11): 1015-1017.
[8]	ZHAI Hong-wei. Application and Development of the Static Balance Test and Training Equipment in Clinical Rehabilitation (review) [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2006, 12(10): 888-889.
[9]	LIU Jing-hui;YU Bo;WANG Zheng-he. Manipulation on Cervical Vertigo Following Atlantoaxial Joint Malposition: a 40 Cases Report [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2006, 12(06): 525-526.
[10]	ZHU Qi;QIAO Lei;YANG Jian;et al. Effect of Visual Compensation on Balance Function of Post-stoke Hemiplegic Patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2006, 12(02): 143-144.