Article record

单侧前庭功能减退患者主观平衡信心与客观表现之间差异相关的心理因素

Psychological Factors Associated With Discrepancies Between Subjective Balance Confidence and Objective Performance of Patients With Unilateral Vestibular Hypofunction.

临床研究耳科IF 1.9Q2

文献信息

PMID	42831392
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Hirofumi Ogihara 查看其他 6 位作者 Tomohiko Kamo；Masato Azami；Ryozo Tanaka；Takumi Kato；Reiko Tsunoda；Hiroaki Fushiki
作者单位	Otolaryngology, Mejiro University Ear Institute Clinic, Saitama, Japan. 查看其他 4 条单位信息 Department of Rehabilitation, Division of Physical Therapy, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan.；Department of Physical Therapy, Faculty of Rehabilitation, Gunma Paz University, Gunma, Japan.；Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, Saitama, Japan.；Department of Physical Therapy, Faculty of Health Sciences, Mejiro University, Saitama, Japan.
期刊	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
SCI 分区	Q2
IF	1.9
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

目的： 在单侧前庭功能减退患者中，主观平衡信心与客观表现之间的差异可能具有临床后果。高估可能增加跌倒风险，而低估可能导致不必要的活动限制。其相关因素尚不清楚。
研究设计： 观察性研究。
地点： 一家初级保健门诊诊所。
患者： 本研究纳入160例单侧前庭功能减退患者。
主要结局指标： 主观-客观平衡差异通过活动特异性平衡信心量表和功能性步态评估的z分数标准化进行量化（Z_ABC-Z_FGA）。采用带交互项的层次回归分析，检验头晕相关残疾、焦虑和抑郁（医院焦虑抑郁量表，HADS）之间的关联。
结果： 54.4%的患者观察到高估；其余45.6%为低估。高估组的头晕相关残疾低于低估组（33.6±21.0 vs. 45.8±22.0，P=0.001）。头晕相关残疾与差异评分独立相关（β=-0.327，P<0.001）。在采用二分类临床HADS分类的探索性分析中，焦虑（β=-0.315，P<0.001）和抑郁（β=-0.224，P=0.010）与更明显的低估相关，而在高估组中这种关联减弱。这些关联仅在使用连续HADS评分时部分重现。
结论： 焦虑和抑郁与这种差异相关，主要见于低估自身平衡能力的患者，而头晕相关残疾则与其独立相关。这些发现提示，心理困扰与对平衡的负面自我评价有关，在解读前庭康复中自我报告的平衡信心时，应将其与基于表现的评价一并考虑。

英文摘要

OBJECTIVE: Discrepancies between subjective balance confidence and objective performance may have clinical consequences in patients with vestibular hypofunction. Overestimation may increase fall risks, whereas underestimation may lead to unnecessary activity restriction. The contributing factors remain unclear.
STUDY DESIGN: Observational study.
SETTING: A primary care outpatient clinic.
PATIENTS: This study included 160 patients with unilateral vestibular hypofunction.
MAIN OUTCOME MEASURES: The subjective-objective balance discrepancy was quantified using z-score standardization of the Activities-specific Balance Confidence Scale and Functional Gait Assessment (Z_ABC-Z_FGA). Associations between dizziness-related disability, anxiety, and depression (Hospital Anxiety and Depression Scale, HADS) were examined using hierarchical regression with interaction terms.
RESULTS: Overestimation was observed in 54.4% of patients; the remaining 45.6% underestimated it. The overestimation group showed lower dizziness-related disability than the underestimation group (33.6±21.0 vs. 45.8±22.0, P=0.001). Dizziness-related disability was independently associated with discrepancy scores (β=-0.327, P<0.001). In exploratory analyses using the dichotomized clinical HADS classification, anxiety (β=-0.315, P<0.001) and depression (β=-0.224, P=0.010) were associated with greater underestimation, attenuated in the overestimation group. These associations were only partly reproduced with continuous HADS scores.
CONCLUSIONS: Anxiety and depression were associated with the discrepancy, mainly in patients who underestimated their balance ability, whereas dizziness-related disability was independently associated with it. These findings suggest that psychological distress relates to negative self-evaluation of balance and should be considered alongside performance-based measures when interpreting self-reported balance confidence in vestibular rehabilitation.