Apparative Messungen des Gleichgewichts im Stand und in Bewegung bei neurologischen Erkrankungen im Alter

Nicht selten werden neurologische Erkrankungen im Alter von Balancestörungen begleitet. Dies bedeutet oftmals einen gravierenden Einschnitt in die Selbstständigkeit betroffener Personen. Altersbedingte und neurologische Balancestörungen treten sowohl im Stand als auch in der Fortbewegung auf. Bis dato wurde die Diagnostik oder die Verlaufskontrolle vorrangig über funktionelle Messverfahren erhoben. Mittlerweile stehen biomechanische Messverfahren zur Verfügung, um objektive Aussagen treffen zu können. Zu nennen sind hier Balance- oder Ganganalysesensoren, Balancemessplatten, Ganganalysematten usw. Trotz dieser Vielfalt sollte es Ziel sein, mit ein und demselben System mobilitätsrelevante Bewegungen wie Stehen, Gehen oder den Sitz-Stand-Transfer unter alltagsnahen Bedingungen untersuchen zu können.

Abstract

Neurological diseases in older persons are often accompanied by balance dysfunction. This often implies a major decrease of independence for the affected persons. Balance dysfunction caused by age or neurological impairment can be seen in unsupported standing as well as in locomotion. Up to now, assessment and change of performance are documented by functional measures. Meanwhile, biomechanical measures are available for objective measurement, for example: Sensors for balance and gait analysis, force plates and mats for gait analysis. Despite this diversity of measures, research is focused on the development of one sensor to measure unsupported standing, walking and sit-to-stand transfer.

Stichworte:

Neurologische Erkrankungen - Balancestörungen - apparative Messverfahren

Key words:

Neurological disease - balance dysfunction - biomechanical measures

Literatur

• 1 Aminian K, Rezakhanlou K, De Andres E et al. Temporal feature estimation during walking using miniature accelerometers: an analysis of gait improvement after hip arthroplasty.  Med Biol Eng Comput. 1999;  37(6) 686-91
• 2 Bloem B R, Haan J, Lagaay A M et al. Investigation of gait in elderly subjects over 88 years of age.  J Geriatr Psychiatry Neurol. 1992;  5 78-84
• 3 Cutlip R G, Mancinelli C, Huber F et al. Evaluation of an instrumented walkway for measurement of the kinematic parameters of gait.  Gait and Posture. 2000;  12 134-138
• 4 Elble R J. Gait and dementia: moving beyond the notion of gait apraxia.  J Neural Transm. 2007;  114(10) 1253-8
• 5 Gresham G E, Kelly-Hayes M, Wolf P A et al. Survival and functional status 20 or more years after first stroke: the Framingham Study.  Stroke. 1998;  29(4) 793-7
• 6 Guralnik J, Simonsick E, Ferrucci L et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.  J Gerontol. 1994;  49 85-94
• 7 Horak F B, Nashner L M. Central programming of postural movements: adaptation to altered support surface configurations.  J Neurophysiol. 1986;  55 1369-1381
• 8 Jarnlo G B. Functional balance tests related to falls among elderly people living in the community.  Eur J Ger. 2003;  5 7-14
• 9 Le Forestier N, Bouche P. Peripheral neuropathy in the elderly.  Psychol Neuropsychiatr Vieil. 2006;  4 109-19
• 10 Moe-Nilssen R. A new method for evaluation of motor control in gait under real-life environmental conditions Part 1: The instrument.  Clin Biomech. 1998;  13 (4–5) 320-327
• 11 Moe-Nilssen R, Helbostad J L. Trunk accelerometry as a measure of balance control during quiet standing.  Gait Posture. 2002;  16(1) 60-8
• 12 Pajala S, Era P, Koskenvuo M et al. Force platform balance measures as predictors of indoor and outdoor falls in community-dwelling women aged 63–76 years.  J Gerontol Med Sci. 2008;  63 A 171-178
• 13 Perry J. Gait analysis: normal and pathological function. Thorofare: Slack; 1992
• 14 Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons.  J Am Geriatr Soc. 1991;  39 142-148
• 15 Riedel O et al. Cognitive impairment in 873 patients with idiopathic Parkinson's disease. Results from the German Study on Epidemiology of Parkinson's Disease with Dementia (GEPAD).  J Neurol. 2008;  255(2) 255-64
• 16 De Rijk M C et al. Prevalence of Parkinson's disease in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group.  Neurology. 2000;  54(11 Suppl 5) 21-3
• 17 Snijders A, van de Warrenburg B P, Giladi N et al. Neurological gait disorders in elderly people: clinical approach and classification.  Lancet Neurol. 2007;  6 63-74
• 18 Strickland D, Bertoni J M. Parkinson's prevalence estimated by a state registry.  Mov Disord. 2004;  19(3) 318-23
• 19 Sudarsky L. Gait disorders: prevalence, morbidity, and etiology.  Adv Neurol. 2001;  87 111-117
• 20 Tideiksaar R. Stürze und Sturzprävention: Assessment – Prävention Management. Bern: Hans Huber; 2000
• 21 Ward A, Payne K A, Caro J J et al. Care needs and economic consequences after acute ischemic stroke: the Erlangen Stroke Project.  Eur J Neurol. 2005;  12(4) 264-7
• 22 Winter D A. Human balance and posture control during standing and walking.  Gait & Posture. 1995;  3 193-214
• 23 World Health Organization .Cerebravascular Disorders (Offset Publications). Geneva: World Health Organization; 1978
• 24 Zijlstra W. Assessment of spatio-temporal parameters during unconstrained walking.  Eur J Appl Physiol. 2004;  92(1–2) 39-44

Korrespondenzadresse