Bulletin of Rehabilitation MedicineBulletin of Rehabilitation MedicineВестник восстановительной медицины2078-19622713-2625National Medical Research Center for Rehabilitation and Balneology608824ArticlesСтатьиResearch ArticleTestirovanie balansa v vertikal'nom polozhenii i funktsii khod'by u bol'nykh s tserebral'nym insul'tomТестирование баланса в вертикальном положении и функции ходьбы у больных с церебральным инсультомSkvortsovaV. IСкворцоваВ. И

Министр здравоохранения РФ, д.м.н., профессор, член-корреспондент РАМН

dskvorts63@mail.ruIvanovaG. EИвановаГ. Е

главный специалист Министерства здравоохранения РФ по медицинской реабилитации, д.м.н., профессор

KlimovL. VКлимовЛ. ВSkvortsovD. VСкворцовД. ВНаучно-исследовательский институт цереброваскулярной патологии и инсульта ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздравсоцразвития России15082012114NO4 (2012)№4 (2012)151912102023Copyright ©; 2012, Skvortsova V.I., Ivanova G.E., Klimov L.V., Skvortsov D.V.Copyright ©; 2012, Скворцова В.И., Иванова Г.Е., Климов Л.В., Скворцов Д.В.2012Skvortsova V.I., Ivanova G.E., Klimov L.V., Skvortsov D.V.Скворцова В.И., Иванова Г.Е., Климов Л.В., Скворцов Д.В.https://creativecommons.org/licenses/by/4.0https://journals.eco-vector.com/2078-1962/article/view/608824

We have analyzed routine clinical scales for estimation balance at quite standing and walking at the point of the initial data and its comparability to clinical condition and objective methods by biomechanics devices. Currently at the active using different clinical scales which was worked out as for stroke patients as coming from another specialties. However, at the clinical scales we did not find differentiation of components of analyzed function. Assessment of walking has time-space character and do not include functional biomechanics components.

В работе проанализированы используемые для оценки функции ходьбы и баланса в вертикальной стойке клинические шкалы, с точки зрения того, на основе каких первичных данных проводится оценка и какова её сопоставимость с клиническими данными и результатами объективного анализа посредством специальных приборов. В настоящее время используются шкалы, как первично разработанные для больных после перенесённого инсульта, так и «пришедшие» из других нозологий. В имеющихся шкалах не проводится разделения различных компонентов анализируемой функции. При этом оценка ходьбы носит пространственно-временной характер и не включает собственно функциональные биомеханические составляющие.

Демиденко Т.Д. Реабилитация при цереброваскулярной патологии.- Л.:Медицина, 1989.-208 c.Кадыков А.С., Черникова Л.А., Шахпаронова Н.В. - Реабилитация неврологических больных. МЕДпресс-информ, 2008, с. 564.Коган О.Г., Найдин В.Л. Медицинская реабилитация в неврологии и ней- рохирургии // АМН СССР. – М.: Медицина, 1988. – 304с.Столярова Л.Г., Ткачева Г.Р. Реабилитация больных с постинсультными двигательными расстройствами. М.,Медицина, 1978, 215 с.Черникова Л.А, Устинова К.И., Иоффе М.Е., Ермолаева Ю.А., Слива С.С,, Девликанов Э.О., Переяслов Г.А. Биоуправление по стабилограмме в клинике нервных болезней Бюллетень СО РАМН. №3(113), г.2004,85-91Andersson, A. G., Kamwendo, K., Appelros P. (2006). "How to identify potential fallers in a stroke unit: validity indexes of 4 test methods." J Rehabil Med 38(3): 186-191.Andersson A.G., Kamwendo K., Appelros P. Fear of falling in stroke patients: relationship with previous falls and functional characteristics. Int J Rehabil Res. 2008 Sep;31(3):261-4.Acht V., Bongers E., Lambert N., Verberne R. - Miniature wireless inertial sensor for measuring human motions. Conf Proc IEEE Eng Med Biol Soc. 2007;2007:6279-82.Benaim C., Pérennou D.A., Villy J., Rousseaux M., Pelissier J.Y. - Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS). Stroke. 1999 Sep;30(9):1862-8.Berg K.O., Maki B.E., Williams J.I., Holliday P.J., Wood-Dauphinee S.L. - Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992 Nov;73(11):1073-80.Brooks D., Solway S., Gibbons W.J. ATS statement on six-minute walk test. Am J Respir Crit Care Med. 2003 May 1;167(9):1287.Cohen H.S., Kimball K.T. - Usefulness of some current balance tests for identifying individuals with disequilibrium due to vestibular impairments. J Vestib Res. 2008;18(5-6):295-303.Collin C., Wade D. Assessing motor impairment after stroke: a pilot reliability study. J Neurol. Neurosurg Psychiatry 1990 Jul;53(7):576-9.Collen F. M., Wade D. T., Bradshaw CM. Mobility after stroke: reliability of measures of impairment and disability. Int Disabil Stud. 1990 Jan-Mar;12(1):6-9.Collen F.M., Wade DT, Robb GF, Bradshaw CM. The Rivermead Mobility Index: a further development of the Rivermead Motor Assessment. IntDisabil Stud. 1991 Apr-Jun;13(2):50-4.Demeurisse G., Demol O., Robaye E. Motor evaluation in vascular hemiplegia. EurNeurol 1980;19(6):382-9.Evans M.K., Krebs D.E. - Posturography does not test vestibulospinal function. Otolaryngol Head Neck Surg. 1999 Feb;120(2):164-73.Fugl-Meyer A.R., Jaasko L., Leyman I., Olsson S., Steglind S. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med 1975; 7:13-3Fahn S., Elton R., Members of the UPDRS Development Committee. In: Fahn S, Marsden CD, Calne DB, Goldstein M, eds. Recent Developments in Parkinson’s Disease, Vol. 2. Florham Park, NJ. Macmillan Health Care Information 1987, pp 153-163, 293-304Flansbjer et al, 2005 "Reliability of gait performance tests in men and women with hemiparesis after stroke." J Rehabil Med 37(2): 75-82.Fulk G.D., Echternach J.L. Test-retest reliability and minimal detectable change of gait speed in individuals undergoing rehabilitation after stroke. J Neurol Phys Ther. 2008 Mar;32(1):8-13.Janssen W.G., Külcü D.G., Horemans H.L., Stam H.J., Bussmann J.B. - Sensitivity of accelerometry to assess balance control during sit-to-stand movement. IEEE Trans Neural Syst Rehabil Eng. 2008 Oct;16(5):479-84.Jonsdottir J. and Cattaneo, D. (2007). "Reliability and validity of the dynamic gait index in persons with chronic stroke." Archives of physical medicine and rehabilitation 88(11): 1410-1415.Hsueh, I. P., Wang, C.-H., et al. (2003). "Comparison of psychometric properties of three mobility measures for patients with stroke." Stroke 34: 1741-1745.Kosak M, Smith T. Comparison of the 2-, 6-, and 12-minute walk tests in patients with stroke. J Rehabil Res Dev. 2005 Jan-Feb;42(1):103-7.Lam T., Luttmann K. - Turning capacity in ambulatory individuals poststroke. Am J Phys Med Rehabil. 2009 Nov;88(11):873-83Longridge N.S., Mallinson A.I. - Clinical romberg testing does not detect vestibular disease. Otol Neurotol. 2010 Jul;31(5):803-6.Michel-Pellegrino V, Hewson DJ, Drieux M, Duchêne J. - Evaluation of the risk of falling in institution-dwelling elderly: clinical tests versus biomechanical analysis of stepping-up. Conf Proc IEEE Eng Med Biol Soc. 2007;2007:6122-5.Mizuike C., Ohgi S., Morita S. - Analysis of stroke patient walking dynamics using a tri-axial accelerometer. Gait Posture. 2009 Jul;30(1):60-4. Epub 2009 Apr 5.Ng S.S., Hui-Chan C.W. - The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil. 2005 Aug;86(8):1641-7.Ortuño-Cortés MA, Martín-Sanz E, Barona-de Guzmán R. - Static posturography versus clinical tests in elderly people with vestibular pathology. [Article in Spanish] Acta Otorrinolaringol Esp. 2008 Aug-Sep;59(7):334-40.Oliveira C.B., Medeiros I.R., Frota N.A., Greters M.E., Conforto A.B. - Balance control in hemiparetic stroke patients: main tools for evaluation. J Rehabil Res Dev. 2008;45(8):1215-26.Patterson, S., Forrester, L., et al. (2007). "Determinants of walking function after stroke: differences by deficit severity." Archives of physical medicine and rehabilitation 88(1): 115-119.Podsiadlo, D., Richardson, S. (1991). "The timed "Up & Go": a test of basic functional mobility for frail elderly persons." J Am Geriatr Soc 39(2): 142-148.Sechi G, Deledda MG, Bua G, Satta WM, Deiana GA, Pes GM, Rosati G. Reduced intravenous glutathione in the treatment of early Parkinson's disease. Prog Neuropsychopharmacol Biol Psychiatry. 1996 Oct;20(7):1159-70.Thomas M., Jankovic J, Suteerawattananon M, Wankadia S, Caroline KS, Vuong KD, Protas E. Clinical gait and balance scale (GABS): validation and utilization. J Neurol Sci. 2004 Jan 15;217(1):89-99.Tinetti M.E. Performance-oriented assessment of mobility problems inelderly patients. J Am GeriatrSoc 1986;34(2):119 –26.Yelnik A., Bonan I. - Clinical tools for assessing balance disorders. Neurophysiol Clin. 2008 Dec;38(6):439-45. Epub 2008 Oct 18.Wade D.T., Collen FM, Robb GP, Warlow CP. Physiotherapy intervention late after stroke and mobility. BMJ 1992 Mar 7;304(6827):609-13.Webster D.D. Critical analysis of the disability in Parkinson’s disease.Mod Treat 1968;5(2):257 –82.Wrisley D.M., Marchetti G.F., Kuharsky D.K., Whitney S.L. Reliability, internal consistency, and validity of data obtained with the functional gait assessment. Phys Ther. 2004 Oct;84(10):906-18.Wrisley D., Kumar N. (2010). "Functional Gait Assessment: concurrent, discriminative, and predictive validity in community-dwelling older adults." Physical Therapy 90(5): 761.