ミニシンポジウム２「姿勢・歩行・転倒について学ぶ」
姿勢歩行障害と転倒の臨床
―重心シフト検査と歩行機能検査による評価―
2021 年 80 巻 6 号 p. 572-579
詳細
2021 年 80 巻 6 号 p. 572-579
Evaluation of human postural stability and gait performance is important to prevent falls. We examined postural and gait function to determine the prevalence of fall risk in patients with unilateral vestibular disorder (UVD). Patients with persistent chronic dizziness and postural imbalance/gait disturbance due to UVD, as determined by significant unilateral caloric canal paresis, received tests of standing balance and gait function, including 4-directional (anterior, posterior, left and right) weight-shifting stabilometry for evaluation of postural stability and Functional Gait Assessment (FGA), and the Timed up and go (TUG) and Gait Speed (GS) test for assessment of dynamic gait function.
The index of postural stability (IPS), the ratio of the range of body movement to the area of body sway as calculated by 4-directional weight-shift stabilometry was used to evaluate the instability of posture and fall risk. The IPS was significantly lower in patients with UVD than in healthy subjects. Increased fall risk, as indicated by an FGA score of less than 22, TUG result of over 11.1 sec or GS of less than 0.85m/sec was detected in 22 (61.1%) of the 36 patients with UVD. Increased fall risk was seen significantly more frequently in patients over 65 years of age than in those under 65 years of age.
These results suggest that it is essential to conduct a precise evaluation of the postural/gait function and fall risk using balance and gait function tests including the weight shifting stabilometry, FGA, TUG and GS, in elderly patients with UVD, to improve balance performances and prevent falls.
