恢復良好的車禍腦傷病患之站立平衡研究－初步報告

Standing Balance in the Traumatic Brain Injured with Good Recovery - A Preliminary Report

曹昭懿(Jau-Yih Tsauo) ； 莊麗玲(Li-Ling Chuang) ； 黃勝堅(Sheng-Jean Huang) ； 胡名霞(Ming-Hsia Hu)

《中華民國物理治療學會雜誌》 24卷5期 (1999/09) Pp. 341-348

https://doi.org/10.29616/JPTAROC.199909.0002

摘要

Traffic-related traumatic brain injury leads to great cost in the society. The medical personnel tend to focus on the management of severely injured patients and ignore those patients with mild injury or who have regained good function. The aims of this study were to explore the balance performance of brain injured patients who had gained good recovery by clinical judgment and to find the possible correlating factors to their balance performance. Twenty patients (age range 18 to 73 years) were recruited from the neurosurgical department of a medical center from May 1998 to March 1999. All the patients sustained traffic-related brain injury with initial Glasgow Coma Scales between 3 to 15 points, among them, 4 were severe injury, 5 were moderate injury and 11 were mild injury. All patients had gained good recovery, i.e. had no motor deficits by clinical standards at the time of balance test. The patients were tested on a dynamic posturographic system (Smart Balance Master system, NeuroCom Int Inc, Clack mas, Oregon, USA) for a their balance ability. The results revealed no significant difference between the mildly and the moderately or severely injured patients. How-ever, when the patients were compared to the data of normal subjects in the literature, differences in sensory integration ability to maintain balance, in rhythmic weight shifting ability, and in sustained weight shifting ability were apparent. Comparison between age groups (using 65 y/o as cut off point) showed significant difference between the young and the old patients while maintaining balance under sensory changing conditions (sway-referenced surface condition, eyes closed and sway-referenced surface condition, sway-referenced surface and vision condition, and average score)(p＜.05). Furthermore, the older patients weight shift slower in the right-posterior, left-posterior, and left directions than the younger patients (p＜.05). The patients with dizziness (n=15) were less able to maintain stability during the sensory integration test than the patients without dizziness (n=5). We conclude that balance deficits remains to be present in traumatic brain injured patients due to traffic injury who were judged clinically to have gained good recovery. The balance deficits are related to their age and dizziness symptom. Furthermore, the balance deficit is more apparent under sensory changing environment. Clinicians should pay more attention to these patients and their balance deficits.

關鍵字

平衡 ； 感覺整合 ； 腦傷

並列摘要

Traffic-related traumatic brain injury leads to great cost in the society. The medical personnel tend to focus on the management of severely injured patients and ignore those patients with mild injury or who have regained good function. The aims of this study were to explore the balance performance of brain injured patients who had gained good recovery by clinical judgment and to find the possible correlating factors to their balance performance. Twenty patients (age range 18 to 73 years) were recruited from the neurosurgical department of a medical center from May 1998 to March 1999. All the patients sustained traffic-related brain injury with initial Glasgow Coma Scales between 3 to 15 points, among them, 4 were severe injury, 5 were moderate injury and 11 were mild injury. All patients had gained good recovery, i.e. had no motor deficits by clinical standards at the time of balance test. The patients were tested on a dynamic posturographic system (Smart Balance Master system, NeuroCom Int Inc, Clack mas, Oregon, USA) for a their balance ability. The results revealed no significant difference between the mildly and the moderately or severely injured patients. How-ever, when the patients were compared to the data of normal subjects in the literature, differences in sensory integration ability to maintain balance, in rhythmic weight shifting ability, and in sustained weight shifting ability were apparent. Comparison between age groups (using 65 y/o as cut off point) showed significant difference between the young and the old patients while maintaining balance under sensory changing conditions (sway-referenced surface condition, eyes closed and sway-referenced surface condition, sway-referenced surface and vision condition, and average score)(p＜.05). Furthermore, the older patients weight shift slower in the right-posterior, left-posterior, and left directions than the younger patients (p＜.05). The patients with dizziness (n=15) were less able to maintain stability during the sensory integration test than the patients without dizziness (n=5). We conclude that balance deficits remains to be present in traumatic brain injured patients due to traffic injury who were judged clinically to have gained good recovery. The balance deficits are related to their age and dizziness symptom. Furthermore, the balance deficit is more apparent under sensory changing environment. Clinicians should pay more attention to these patients and their balance deficits.

並列關鍵字

Balance ； Dynamic posturography ； Traumatic brain injury