使用四阶段平衡测试结合前庭挑战进行移动端跌倒风险筛查

文献信息

中文摘要

目的： 本研究旨在探索使用移动设备技术测量姿势稳定性，并评估在65岁以上成年人中，于四阶段平衡测试（4SBT）中加入动态前庭任务的初步效果。研究假设加入动态前庭任务会使4SBT在识别跌倒风险方面更敏感。
方法： 28名年龄70至100岁的成年人完成了4SBT，分别在有和没有加入前庭挑战（即有无摇头）的条件下进行。使用移动设备测量姿势摇摆。参与者还完成了Stay Independent Questionnaire（SIQ），并提供了自我报告的跌倒和健康史。比较不同条件下的摇摆评分差异。相关性分析评估了跌倒史、跌倒风险和摇摆评分之间的关联。
结果： 加入摇头任务后，所有4SBT阶段的姿势摇摆均显著增加。自我报告的跌倒风险不能由摇摆评分预测；然而，在更具挑战性的平衡条件下，自我报告的跌倒风险与摇摆之间存在显著相关性，且这些关系在加入动态前庭任务后基本未改变。尽管摇摆评分不能可靠区分报告跌倒与未报告跌倒的个体，但跌倒史与自我报告的跌倒风险和跌倒恐惧呈中度相关。
结论： 在更具挑战性的平衡条件下测量的SIQ与摇摆评分之间存在显著相关性。即使加入动态前庭任务，这些关系总体保持稳定，提示SIQ可能反映涉及前庭输入的现实世界平衡挑战。自我报告的跌倒恐惧或感知跌倒风险可能捕捉了摇摆评分未直接反映的不平衡方面。需要更大、更多样化样本的进一步研究，以评估摇摆评分在感知不平衡之外识别跌倒风险的附加临床效用。

英文摘要

PURPOSE: The purpose of this study is to explore the use of mobile device technology to measure postural stability and to assess the preliminary effect of an added dynamic vestibular task in the 4-Stage Balance Test (4SBT) in adults over 65 years. It was hypothesized that adding a dynamic vestibular task would make the 4SBT more sensitive in identifying fall risk.
METHOD: Twenty-eight adults aged 70-100 years completed the 4SBT with and without an added vestibular challenge (i.e., with and without a headshake). Postural sway was measured using a mobile device. Participants also completed the Stay Independent Questionnaire (SIQ) and provided self-reported fall and health history. Differences in sway score were compared between conditions. Correlational analyses assessed the association between fall history, fall risk, and sway scores.
RESULTS: The addition of a headshake task significantly increased postural sway across all 4SBT stages. Self-reported fall risk was not predicted by sway score; however, significant correlations were observed between self-reported fall risk and sway in more challenging balance conditions, and these relationships were largely unchanged with the added dynamic vestibular task. Although sway score did not reliably distinguish between individuals who did and did not report a fall, fall history was moderately associated with self-reported fall risk and fear of falling.
CONCLUSIONS: Significant correlations were observed between SIQ and sway score measured in the more challenging balance conditions. These relationships generally remained stable even with the added dynamic vestibular task, suggesting that the SIQ may reflect real-world balance challenges involving vestibular input. Self-reported fear of falling or perceived fall risk likely captures aspects of imbalance not directly reflected in sway scores. Further research with larger, more diverse samples is warranted to assess added the clinical utility of sway score beyond perceived aspects of imbalance to identify fall risk.