Vol. 3, No 1, 2005 pp. 59 - 68
UDC 616.8-009.11:616.88-009.18
Scientific Paper
STANDING STABILITY OF HEMIPARETIC
PATIENTS
ESTIMATED IN DIFFERENT WAYS
Mónika Horváth1, M. Fazekas2,
Tekla Tihanyi1, József Tihanyi1
1Semmelweis University, Faculty of
Physical Education and Sport Science
2Saint John Hospital, Budapest,
Hungary
E-mail: tihany@mail.hupe.hu
Abstract. The objective of the present study was to investigate
the postural stability of hemiplegic patients as opposed to that of
healthy
subjects and to compare patients with right or left hemispheric
lesions.
Twenty hemiparetic patients (12 female and 8 male) and nine healthy
subjects
of the same age (8 females and 2 males) volunteered for the study. The
subjects were tested under three conditions. 1. Habitual, quiet
standing
on both feet for 1 minute, eyes open or closed. The centre of pressure
excursion was determined. 2. Measurement of body sway which determines
head and shoulder movement as part of the Romberg test. 3. The Fukuda
stepping
test. The length of the excursion of the centre of pressure for
hemiplegic
subjects was longer than for the healthy subjects especially in the
eyes
closed condition. Body sway was significantly greater for patients with
right hemisphere lesions. In the Romberg test the hemiparetic patients
showed longer anteror-posterior and latero-medial head excursions
compared
to normal subjects. The patients with right hemisphere lesions
displayed
greater values than the patients with a right hemiparesis except for
the
neck tilt. In the Fukuda stepping test the forward, lateral and angle
deviation,
and rotation on the vertical axis were significantly greater for
hemiparetic
subjects. The left side paretic patients showed greater forward
deviation,
but significantly less rotation on the vertical axis. We concluded that
the visual input plays a more significant role for hemiparetic patients
than for healthy people. Right hemisphere lesions, compared to those of
the left hemisphere, worsen standing stability. It seems that the
vestibular
area in the central nervous system was damaged in most of the patients
studied because the side on which the hemisphere lesion was located had
a greater influence on body rotation and lateral deviation than the
side
dominance.
Key words: hemiplegia, body sway, stepping test.
TELESNA STABILNOST HEMIPARETIČNIH
PACIJENATA
SA RAZLIČITIM PROCENAMA
Cilj ove studije je bio da se ispita posturalna stabilnost
hemiplegičnih
pacijenata u odnosu na zdrave osobe kao i uporedjenje stanja pacijenata
sa lezijom leve ili desne hemisfere. Uzorak je činilo 20 hemiparetičnih
pacijenata (12 žena i 8 muškaraca) i 10 zdravih osoba iste starosne
dobi
(osam žena i dva muškarca). Ispitanici su testirani na tri različita
načina.
1. Uobičajeno, mirno stajanje na obe noge u roku od jedne minute sa
otvorenim
ili zatvorenim očima. Tako se odredjivao centar pritiska. 2. Merio se
otklon
tela odnosno kretanje glave i ramena putem Rombergovog testa. 3. Radjen
je Fukuda steping test. Dužina izmeštanja centra pritiska kod
hemiplegičnih
pacijenata je bila veća u odnosu na zdrave osobe naročito kada su im
oči
bile zatvorene. Otklon tela je bio značajno veći kod pacijenata sa
lezijom
desne hemisfere. Kada je radjen Rombergov test hemiparetični pacijenti
su pokazali duže anteriorno-posteriorno i lateralno-medijalno okretanje
glave u poredjenju sa zdravim ispitanicima. Pacijenti sa lezijom desne
hemisfere su pokazali veće vrednosti u odnosu na paretične pacijente na
desnoj strani tela, osim dužine okreta vrata.
Prilikom primene Fukuda steping testa lateralna, ugaona i devijacija
unapred kao i rotacija oko vertikalne ose su bile znatno veće kod
hemipareticnih
ispitanika. Pacijenti sa parezom na levoj strani su pokazali vežu
devijaciju
u kretanju napred ali su zato imali značajno manju rotaciju oko
vertikalne
ose. Mi smo, stoga zaključili da vizuelni input ima mnogo veću ulogu
kod
hemiparetičnih pacijenata nego li kod zdravih osoba. Lezija desne
hemisfere
u mnogome pogoršava telesnu stabilnost pacijenata nego li kada je u
pitanju
lezija leve hemisfere. Čini se da je vestibularna oblast u centralnom
nervnom
sistemu bila oštećena kod većine ispitanih pacijenata zato što je
strana
lezije hemisfere imala veći uticaj na rotaciju tela i lateralnu
devijaciju
nego li dominantnost strane oštećenja.
Ključne reči: hemiplegija, otklon tela, steping test.
