中国卒中患者SOT综合评分与Berg平衡量表评分的独立相关性：一项回顾性横断面研究

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中文摘要

目的： 卒中相关平衡功能障碍影响61%-83%的患者，但感觉整合能力与功能性平衡之间的定量关系仍未得到充分描述。本研究探讨了中国卒中患者感觉组织试验（SOT）综合评分与Berg平衡量表（BBS）表现之间的相关性。
方法： 本回顾性横断面研究分析了2021年1月至2023年12月在广东三九脑科医院接受治疗的339例卒中患者的数据。暴露变量为SOT综合评分（0-100分，于48小时内通过NeuroCom Smart EquiTest测量）。结局变量为Berg平衡量表总分（0-56分，于48小时内评估）。构建了两个模型：核心模型校正年龄、性别、诊断和病程，敏感性模型额外校正Brunnstrom下肢分期和体重对称指数。对SOT综合评分进行三分位分层描述性分析，以探索剂量-反应模式。
结果： 在敏感性模型中，SOT综合评分每增加1分，Berg平衡量表评分相应高0.2745分（95% CI：0.171-0.386，p < 0.001；核心模型：β = 0.2471，95% CI 0.137-0.357，p < 0.001）。敏感性模型中的标准化系数分析显示，Brunnstrom下肢分期的相关性最强（标准化β = 0.4562，p < 0.001），其次是SOT综合评分（标准化β = 0.2527，p < 0.001）。在感觉子系统中，视觉、躯体感觉和前庭处理比率均与平衡表现显著相关（非标准化β分别为每单位比率变化0.18、0.16和0.15个BBS分）。
结论： 在卒中患者中，SOT综合评分与Berg平衡量表表现独立相关，即使在校正多个协变量后亦然。针对性感觉训练能否改善平衡结局，尚需在未来前瞻性干预研究中评估。

英文摘要

OBJECTIVE: Stroke-related balance dysfunction affects 61-83% of patients, yet the quantitative relationship between sensory integration capacity and functional balance remains inadequately characterized. This study investigated the association between Sensory Organization Test (SOT) composite scores and Berg Balance Scale (BBS) performance in Chinese stroke patients.
METHODS: This retrospective cross-sectional study analyzed data from 339 stroke patients who received treatment at Guangdong 999 Brain Hospital between January 2021 and December 2023. Exposure variable was SOT-Composite score (0-100 points, measured via NeuroCom Smart EquiTest within 48 h). Outcome variable was Berg Balance Scale total score (0-56 points, assessed within 48 h). Two models were constructed: a Core model adjusting for age, gender, diagnosis, and disease duration, and a Sensitivity model additionally adjusting for Brunnstrom lower-extremity stage and weight symmetry index. Tertile stratification of SOT-Composite scores was performed descriptively to explore dose-response patterns.
RESULTS: In the Sensitivity model, each 1-point increase in SOT-Composite score was associated with a 0.2745-point higher Berg Balance Scale score (95% CI: 0.171-0.386, p < 0.001; Core model: β = 0.2471, 95% CI 0.137-0.357, p < 0.001). Standardized coefficient analysis in the Sensitivity model showed Brunnstrom lower-extremity stage had the strongest association (standardized β = 0.4562, p < 0.001), followed by SOT-Composite score (standardized β = 0.2527, p < 0.001). Among sensory subsystems, visual, somatosensory, and vestibular processing ratios were all significantly associated with balance performance (unstandardized β = 0.18, 0.16, and 0.15 BBS points per unit ratio change, respectively).
CONCLUSION: SOT-Composite score was independently associated with Berg Balance Scale performance in stroke patients, even after adjustment for multiple covariates. Whether targeted sensory training can improve balance outcomes warrants evaluation in future prospective intervention studies.