中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (6): 1208-1213.doi: 10.12307/2025.321

• 组织构建与生物力学 tissue construction and biomechanics • 上一篇    下一篇

老年特发性正常压力脑积水患者的姿势稳定性特征

梁晓笑1，郑洁皎1，2，段林茹2，陈  茜1，张廷宇1   

  1. 1上海中医药大学康复医学院，上海市  201203；2复旦大学附属华东医院，上海市  200040


  • 收稿日期:2024-02-05 接受日期:2024-04-03 出版日期:2025-02-28 发布日期:2024-06-21
  • 通讯作者: 郑洁皎，教授，上海中医药大学康复医学院，上海市 201203；复旦大学附属华东医院，上海市 200040
  • 作者简介:梁晓笑，男，1996年生，安徽省宿州市人，汉族，上海中医药大学硕士，初级治疗师，主要从事中枢神经系统疾病患者的姿势控制能力研究。
  • 基金资助:
    上海市科委“科技创新行动计划”项目(22Y31900200)，项目参与人：郑洁皎

Characterization of postural stability in elderly patients with idiopathic normal pressure hydrocephalus #br#
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Liang Xiaoxiao1, Zheng Jiejiao1, 2, Duan Linru2, Chen Xi1, Zhang Tingyu1   

  1. 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; 2Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
  • Received:2024-02-05 Accepted:2024-04-03 Online:2025-02-28 Published:2024-06-21
  • Contact: Zheng Jiejiao, Professor, School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
  • About author:Liang Xiaoxiao, Master, Therapist, School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
  • Supported by:
    Shanghai Municipal Science and Technology Commission Program - "Science and Technology Innovation Action Plan," No. 22Y31900200 (to ZJJ [project participant])

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摘要：




文题释义：
特发性正常压力脑积水：是正常压力脑积水的特殊形式，好发于60岁以上的老年人，呈进展性起病，主要表现为步态障碍、认知障碍和尿失禁典型三联征，严重影响患者的日常生活活动能力。
姿势稳定性：是人在静态和动态活动中保持身体平衡的能力，需要有精确的感觉信息输入、正常的中枢整合能力和快速的运动反应系统共同参与。

背景：姿势控制能力受损是特发性正常压力脑积水患者发生跌倒、引发继发性损害的重要危险因素，现有研究大多是对患者直线行走时的步态参数进行分析，鲜有对患者在静态与动态活动中的姿势稳定性特征进行分析。
目的：分析老年特发性正常压力脑积水患者的姿势稳定性特征。
方法：选择2022年9月至2023年2月在上海市复旦大学附属华东医院神经外科临床诊断为特发性正常压力脑积水的患者22例作为患者组，同时选择健康陪诊家属18名作为健康对照组。分别采用计时起立-行走测试、多方向性伸展测试、Berg平衡量表和静态平衡功能测试(反应时间、移动速度、方向控制、最大偏移距离、端点行程)评估受试者的姿势稳定性特征。
结果与结论：①患者组完成计时起立-行走测试所需时间及静态平衡功能测试的反应时间均长于健康对照组(P < 0.05)，前、后、左、右方向上的伸展测试手臂伸展距离均小于健康对照组(P < 0.05)，Berg平衡量表得分低于健康对照组(P < 0.05)，静态平衡功能测试的移动速度、方向控制、最大偏移距离和端点行程均小于健康对照组(P < 0.05)。②结果提示，特发性正常压力脑积水患者表现出整体的姿势控制能力障碍，反应能力与执行能力受损使得这类患者在面对来自内部或外部的干扰时无法做出及时、准确的运动反应而出现姿势不稳，增加了发生跌倒的风险。

关键词: 特发性正常压力脑积水, 姿势控制, 姿势稳定性, 跌倒风险, 平衡功能

Abstract:
BACKGROUND: Impaired postural control is an important risk factor for falls and secondary damage in patients with idiopathic normal pressure hydrocephalus. Most of the existing studies have analyzed the gait parameters of patients during straight-line walking, but few have analyzed the postural stability characteristics of patients during static and dynamic activities.
OBJECTIVE: To analyze the characteristics of postural stability in elderly patients with idiopathic normal pressure hydrocephalus.
METHODS: Twenty-two patients clinically diagnosed with idiopathic normal pressure hydrocephalus at the Department of Neurosurgery, Huadong Hospital Affiliated to Fudan University, Shanghai, China, from September 2022 to February 2023 were selected as the patient group, and 18 healthy accompanying family members were selected as the healthy control group. The postural stability characteristics of the subjects were assessed using the Timed Up-and-Go Test, Multi-Directional Reach Test, Berg Balance Scale, and Static Balance Function Test (reaction time, speed of movement, directional control, maximum offset distance, and endpoint travel).
RESULTS AND CONCLUSION: The time required to complete the Timed Up-and-Go Test was significantly longer in the patient group than in the healthy control group (P < 0.05). The results of the stretching test in the four directions of anterior, posterior, left and right were significantly lower in the patient group than in the healthy control group (P < 0.05). The Berg Balance Scale scores in the patient group were lower than those in the healthy control group (P < 0.05). In the Static Balance Function Test, the results of reaction, movement speed, directional control, maximum offset distance and endpoint travel index were smaller in the patient group than the healthy control group (P < 0.05). To conclude, patients with idiopathic normal pressure hydrocephalus exhibit overall postural control deficits, and impaired reaction and execution abilities make these patients unable to make timely and accurate motor responses in the face of disturbances from internal or external sources, resulting in postural instability and increasing the risk of falls. 

Key words: idiopathic normal pressure hydrocephalus, posture control, postural stability, fall risk, balance function

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