- 作者: 胡名霞; 洪亞青; 黃于倫; 彭建達; 許書旋
- 作者服務機構: 台大醫學院物理治療學系
- 中文摘要: 維持平衡的感覺整合能力,即在不同感覺環境下保持站立平衡並避免跌倒,是構成良好平衡的要素之一。動態姿勢平衡儀檢查中的感覺整合平衡測驗可在實驗室中模擬各類感覺衝突或感覺剝奪的環境,以測力板記錄受試者之站立穩定度,已被廣泛應用於檢查各年齡層及各類病人的平衡能力。感覺整合平衡測驗之測力板結果,一般以計算成平衡指數(在前後方向之最大擺動範圍)或擺動面積指數(在水平面上之最大擺動範圍)來量化站立穩定度。本實驗即比較平衡指數及擺動面積指數對於分辨不同感覺情境、測驗回數及性別效應之效度。 感覺整合平衡測驗共有六種感覺情境:睜眼、閉眼、視覺屏障擺動(視覺屏障跟隨受試者之自發性身體擺動而同步、同幅擺動)、站立平面擺動(站立平面,即測力板,跟隨受試者之自發性身體擺動而同步、同幅擺動)、閉眼及站立平面擺動、視覺屏障及站立平面擺動、視覺屏障及站立平面同時擺動。閉眼造成視覺剝奪的感覺情境,視覺屏障或站立平面擺動則造成視覺或體感覺與其餘感覺衝突的情境。每一感覺情境重覆測驗三回,每回二十秒。 結果顯示,平衡指數與擺動面積指數之皮爾森相關係數除睜眼的第一回測試較低外,皆有顯著相關(p<.0001)。對於分辨六種感覺情境之計分一致性,兩種指數皆相當高,且擺動面積指數之一致性(Kendall's W=0.866)略高於平衡指數的一致性(Kendall's W=0.843)。以任一指數做變異性統計分析皆可成功檢驗出感覺情境及測驗回數對站立穩定度之顯著影響效果,並同時發現穩定度不受性別影響。 本實驗結論是,平衡指數與擺動面積指數於感覺整合平衡測驗之效度皆相當高。由於擺動面積指數對於分辨六種感覺情境之計分一致性略高,且此指數曾使用於其他類的感覺平衡測驗,因此是較佳之量化方法。
- 英文摘要: Maintaining stance stability under varying sensory environment is an essential function in theelderly and among patients. Testing sensory organization ability of standing balance, the Sensory Organi-zation Test (SOT), has become a standard procedure in many clinical and laboratory settings. The stancestability can be quantified by two forceplate measures in the SOT: the equilibrium score (ES) and thesway area (SA). This study compares the validity of the ES and the SA in detecting gender, trial, andsensory effects on stability in twenty (ten male, ten female) healthy young adults. Subjects were testedunder six sensory conditions: eyes open (E0), eyes closed (EC), sway-referenced vision (Vs), sway-refer-enced support surface (Ss), eyes closed sway-referenced support surface (ECSs), and sway-referencedvisual surround and support surface (VsSs). A visual surround and/or the support surface were tilted pro-portionately to the subject's spontaneous sway in the sway-referenced conditions. Three trials, 20-secondfor each trial, were repeated for each sensory condition. Above results demonstrated that the Pearsoncorrelation coefficients between the ES and the SA were all highly significant (p < .0001) except for thefirst trial of the EO condition. The consistencies in which the two measures discriminated among sensoryconditions were tested by the Kendall's coefficient of concordance. The Kendall's coefficient for the ES(W = .843) and the SA (W = .866) were high and similar. Separate ANOVA procedure for the ES andSA revealed that both measures satisfactorily detected a significant sensory condition and trial effects andinsignificant gender effect. We can conclude that ES and SA are valid measures of stance stability duringthe SOT. Our results confirm that heathy young adults have a poorer postural stability when the visualand somatosensory inputs are simultaneously altered. Moreover, the learning effect is observed duringrepeated trials within test conditions.
- 中文關鍵字: sensory organization; postural control; forceplate.
- 英文關鍵字: --