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Orthostatic Postural Deficit in Subjects with Streptococcal Serology-related Unclassified Arthritis of the Lumbopelvis

鏈球菌血清抗體相關的未分類關節炎患者之姿勢失調

摘要


抗鏈球菌抗體O對鏈球菌感染後之反應性關節炎有其診斷上的價值。臨床表徵無法確切歸類之關節炎通常稱之爲“未分類關節炎”。日常生活中姿勢的維持極爲重要,而姿勢維持之功能缺失可能導致軀幹平衡及穩定性的障礙。因此我們假設在骶髂關節問題導致的腰部及骨盆不平衡可能造成姿勢上的改變。本篇研究的目的在於觀察未分類關節炎患者中,高效價抗鏈球菌抗體O的病患是否有明顯姿勢搖晃的現象。所有未分類關節炎患者依據抗鏈球菌抗體O效價的高低分成兩組,並分別進行十種不同姿勢搖晃的觀察與測試。在全部84個受試者中,平均年齡爲23歲(從18.0到36.4歲)。低效價抗鏈球菌抗體O組共38位,其中32位男性及6位女性(數值小於等於116 IU/mL);高效價抗鏈球菌抗體O組共46位,其中36位男性及10位女性(數值大於116 IU/mL)。在所有的姿勢搖晃的測試當中,兩組結果均有明顯的差異。高效價抗鏈球菌抗體O組的患者較低效價組的患者在各種姿勢中搖晃得更厲害。本文推論這種姿勢維持的功能缺失可能與骶髂關節疾患有關。

並列摘要


Titers of antistreptolysin-O (ASO) possess the diagnostic value in discriminating post-streptococcal reactive arthritis. Patients are labeled as ”unclassified arthritis” (UA) while hard to be classified as having a well-defined arthropathy. Posture is important to perform activities of daily living and its abnormality is a negative factor for trunk stability and balance. We hypothesized that an imbalance of the lumbopelvis due to sacroiliac joint disorder might produce a positional change. The purpose of this study was to determine whether there was a difference in postural sway during orthostatic standing in subjects with UA of the lumbopelvis and high ASO titers. All subjects were divided into two groups according to the reference level of ASO titer, and were subjected to ten sway tests to assess postural sway. In a total of 84 subjects, mean age was 23 years (range 18.0-36.4) and two groups included a group of ASO titer ≤ 116 IU/ml (38 in total, 32 men and 6 women) and a group of ASO titer > 116 IU/ml (46 in total, 36 men and 10 women). In comparison of the sway parameters between the two groups, there were significant differences between them in all sway values under all the position conditions tested. Subjects with high level of streptococcal serology demonstrated increased sway on all postural control measures as compared to those with low serology. Proprioceptive deficits measured in this study might be related to the joint disorder.

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