Effect of vestibular-ocular stimulations on the tonic postural system (STP) in a patient with the “disharmonic functional syndrome” 

前庭-眼刺激对 “功能失调综合征”患者姿势张力系统(STP)的影响

Author: Doctor Felice Picariello

Anamnesis既往史

A 63-year-old woman with disharmonic syndrome. She reports postural imbalances and instability during normal daily activities, low back pain, neck pain, and fibromyalgia syndrome. You have performed neurological and vestibular specialist examinations that have given negative results for the pathology; physiatric examination diagnosed with fibromyalgia for which you are under medical treatment. The neuro-postural evaluation resulted in functional disharmonic syndrome. 

有一位患有失调综合征的63岁女性提出了她在日常活动时出现了姿势不平衡、不稳定，且伴随腰痛、颈痛以及纤维肌痛综合征。已经做了相关的神经和前庭的专科检查，病理结果为阴性;后被诊断为纤维肌痛综合症，目前正在接受治疗，她的神经姿势经评估显示为功能失调综合征。

Test with baiobit: 

Bipedal balance test with open eyes, mobility test of the trunk in rotation, and lateralization.

使用baiobit系统进行以下测试:

 睁眼双脚平衡试验、躯干旋转及侧屈活动能力测试。

Program计划

The patient was given postural assessment tests with baiobit for the analysis of the balance especially of postural oscillations and trunk ROM tests for the evaluation of rotations and lateralizations. The latter were repeated and compared after oculomotor stimulations, the vestibular-ocular reflex (VOR), and the optokinetic reflex (OKR).

使用baiobit对患者进行姿势评估测试以分析平衡和姿势摆动，躯干ROM测试评估旋转和侧屈的能力。后者在动眼肌刺激、前庭眼反射(VOR)和光动反射(OKR)后重复并比较。

Stimulations performed: eye convergence, exercises on the Maddox cross, angular and rectilinear accelerations impressed on the head, slipping off the image on the retina due to the movement of the head and the surrounding scenes, combination of VOR with OKR.

所进行的刺激:眼睛内聚、马多克斯十字练习、头部的角加速度和线性加速度，图像因头部和周围场景的移动从视网膜上移出，VOR和OKR的结合。

Results结果

The stimulations had an immediate action on the postural tone, instantly correcting the STP dystonia; showed an objective improvement in postural balance both on the anterolateral and mid-lateral angles of oscillation and on the speed of oscillation. The LFS equilibrium index went from 0.25 to 0.97.

这些刺激对姿势张力很快就有反应，对纠正STP肌张力障碍、前外侧和中外侧摆动角度及摆动速度方面均有客观的改善。LFS均衡指数由0.25上升到0.97。

Effect of vestibular-ocular stimulations on the tonic postural system (STP) in a patient with the disharmonic-baiobit-1 syndrome

Effect of vestibular-ocular stimulations on the tonic postural system (STP) in a patient with the disharmonic-baiobit-2 syndrome

The immediate correction of postural tone asymmetry also characterized a marked improvement in the rotations of the trunk and lateralization of the same, even slightly affecting the pain threshold as evidenced by the vas scales attached to the graphs.

前庭眼刺激对失调综合症-baiobit-1患者姿势张力系统(STP)的影响

前庭眼刺激对失调综合症-baiobit-2患者姿势张力系统(STP)的影响

姿势张力不对称的立即纠正可以改善躯干旋转、侧屈度，甚至对疼痛阈值有轻微影响，这可以从图表上的vas评分得到验证。

Conclusions结论

The case in question is not in itself a treatment report, but specifically a complex model of analysis of the vestibular-ocular role on the postural tonic system and the symmetries of muscle tone. In the presence of patients of this kind, in the absence of a differential diagnosis related to the clinical picture, it is good to seek, through the modern acquisitions and knowledge of functional rehabilitative neurology, in the complex neuro-postural organization the origin of dysfunctional conditions often responsible for non-symptomatic pictures differential but highly disabling for the patient’s daily life. 

这个案例本身并不是一份治疗报告，而是一个分析前庭眼刺激在姿势张力系统和肌肉张力对称作用的复杂模型。对于这种病人,在缺乏相关临床影像鉴别诊断的情况下，可以通过现代的采集方法和功能康复神经学的知识来进行辅助诊断，Baiobit便是一个很好的辅助工具。由于神经姿势组织的复杂结构，功能失调有时虽然在临床影像鉴别无症状但会对病人的日常生活有很大的影响。

相关链接

baiobit三维运动捕捉分析系统

如何测试刚度和下肢反应度？--Baiobit 便携式三维运动捕捉分析系统

IMU-不但可评估，也可训练改善功能（并可按医保收费）