正常人静态平衡功能的分析及评价系统的初步建立
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摘要
平衡功能是指身体自我调整重心并维持姿势稳定的一种能力。人的坐、立、行等日常活动都以完整的平衡功能为基础,然而脑卒中、偏瘫、骨骼损伤、糖尿病等多种疾病常可导致平衡功能障碍。随着医学技术的进步,各种疾病的预防、治疗和康复水平不断提升,推进了人类老年化社会的进程,伤残、病损以及残障的几率相对增加。因此,平衡功能检测技术的临床应用日益受到人们的重视。自19世纪中期,国外开始对平衡功能的进行研究,20世纪70年代开始使用压力板技术评定平衡功能,开启了定量研究平衡功能的历史。迄今为止对静态平衡功能的评定指标也多达百余种,测试姿势各有不同,评价标准说法不一,但尚无有针对性的能反映整体平衡功能的关键性指标提出。
本文收集前人使用的评价指标,通过大量数据采集及统计分析,从大量备选指标中,筛选出能反映整体平衡能力的关键性指标,主要工作如下:
1、平衡仪的设计
分析人体平衡功能检测仪器的设计需求,研制一种能够满足本研究需求的平衡仪,建立平衡功能的备选评价指标集。
2、基于重复性分析平衡测试指标的一次筛选
为了验证人体平衡仪测试系统的重复性,本论文选取少量人群进行重复测试。并通过重复性的统计学验证,对大量测试指标进行初步筛选,保留重复性良好的指标,剔除变化较大的指标。
3、基于年龄-平衡测试指标趋势图的二次筛选
在平衡功能评价指标初步筛选的基础上,绘制出各指标随年龄变化的趋势图,剔除随年龄变化较凌乱的指标,保留规律性强的指标,并由平衡功能与年龄的关系图中得出平衡功能最佳年龄段;对大于最佳年龄段的人群,进行每一个指标与年龄的相关性分析,并按照相关系数的大小排序;对最佳年龄段与青年人和老年人分别进行差异性分析,并对相关性的高低进行排序;融合上述的系统分析,完成平衡评价指标的第二轮筛选。
4、基于主成分分析平衡测试指标的三次筛选
在二次筛选的基础上,针对整个人群做主成分分析,按照各个指标的方差贡献率排序,筛选出关键性指标,建立评价指标体系。
5、建立评分标准
针对所建立的评价指标体系,绘制出各指标的年龄分布图,根据主成分分析中的因子个数及各关键性指标的均值及标准差,并建立了评分标准。
The balanced function is refers to the bodily self-adjustment center of gravity and maintains the posture stable one kind of capability. People sits, stand, line and other daily activities are based on the complete balance function. However, the apoplexy, hemiplegics, the skeleton damage, the diabetes and other diseases often can lead to balance dysfunction. With advances in medical technology, a variety of disease prevention, treatment and rehabilitation ladder, and pushed forward the process of human aging society, the disabled, lesions, and the relative risk of disability increases. Therefore, the clinical application of balance function test increases people's attention.
Since the mid-19th century, foreigners start to study on balance function. People started to use the pressure plate technology evaluation balanced function in the 1970s. And this has opened the history of the quantitative investigation balanced function. So far, there are hundreds of static balance function index. The test posture has the difference respectively. And the evaluation criteria have different explanations too. But there is no key index to reflect the overall balance function. This paper collects the previous evaluation criteria. Through mass data gathering and the statistical analysis, this paper proposed the key index which can reflect the overall balance from a large number for alternative indexes. The main content includes as follows.
1. The balancing apparatus' design. Through analyzing the design requirements of the human balanced function testing equipment, this paper develop a balanced apparatus to meet the research needs and establish the alternative evaluation index set of balance function.
2. The first filter of repetitive analysis of the balance testing index. This paper selects a few people to repeat the test which is in order to verify the repeatability balance test system of the human being. By repetitive statistical validation, a large number of test targets on a preliminary screening, good indexes of reproducibility are retained and bigger changes of the larger indexes are excluded.
3. The second filter based on the trend map of age-balance testing index. The map of the age changed of different indexes is drawn based on the initial filter of the balance function index. The messy indexes of changed age are removed and the stronger indexes are retained. The best age group is selected from the relationship between the balance function and the age. Analyze the relationship between the age and index of each people who is more than the best crowd. And sort the related coefficient based on size. The second filter of the balanced evaluation index is completed based the proposed system analysis.
4. The third filter of the principal component analysis on the balance testing index. Based on the second filter, the principal analysis is done to the entire crowd. And the key index is selected by the variance of different indexes which are sorted.
5. Establish the scoring criterion. Based on the evaluation index system, the age distribution map of different indexes is drawn. The criterion is established according to the number of principal component analysis of factor and the variance and standard deviations of the key index.
本文收集前人使用的评价指标,通过大量数据采集及统计分析,从大量备选指标中,筛选出能反映整体平衡能力的关键性指标,主要工作如下:
1、平衡仪的设计
分析人体平衡功能检测仪器的设计需求,研制一种能够满足本研究需求的平衡仪,建立平衡功能的备选评价指标集。
2、基于重复性分析平衡测试指标的一次筛选
为了验证人体平衡仪测试系统的重复性,本论文选取少量人群进行重复测试。并通过重复性的统计学验证,对大量测试指标进行初步筛选,保留重复性良好的指标,剔除变化较大的指标。
3、基于年龄-平衡测试指标趋势图的二次筛选
在平衡功能评价指标初步筛选的基础上,绘制出各指标随年龄变化的趋势图,剔除随年龄变化较凌乱的指标,保留规律性强的指标,并由平衡功能与年龄的关系图中得出平衡功能最佳年龄段;对大于最佳年龄段的人群,进行每一个指标与年龄的相关性分析,并按照相关系数的大小排序;对最佳年龄段与青年人和老年人分别进行差异性分析,并对相关性的高低进行排序;融合上述的系统分析,完成平衡评价指标的第二轮筛选。
4、基于主成分分析平衡测试指标的三次筛选
在二次筛选的基础上,针对整个人群做主成分分析,按照各个指标的方差贡献率排序,筛选出关键性指标,建立评价指标体系。
5、建立评分标准
针对所建立的评价指标体系,绘制出各指标的年龄分布图,根据主成分分析中的因子个数及各关键性指标的均值及标准差,并建立了评分标准。
The balanced function is refers to the bodily self-adjustment center of gravity and maintains the posture stable one kind of capability. People sits, stand, line and other daily activities are based on the complete balance function. However, the apoplexy, hemiplegics, the skeleton damage, the diabetes and other diseases often can lead to balance dysfunction. With advances in medical technology, a variety of disease prevention, treatment and rehabilitation ladder, and pushed forward the process of human aging society, the disabled, lesions, and the relative risk of disability increases. Therefore, the clinical application of balance function test increases people's attention.
Since the mid-19th century, foreigners start to study on balance function. People started to use the pressure plate technology evaluation balanced function in the 1970s. And this has opened the history of the quantitative investigation balanced function. So far, there are hundreds of static balance function index. The test posture has the difference respectively. And the evaluation criteria have different explanations too. But there is no key index to reflect the overall balance function. This paper collects the previous evaluation criteria. Through mass data gathering and the statistical analysis, this paper proposed the key index which can reflect the overall balance from a large number for alternative indexes. The main content includes as follows.
1. The balancing apparatus' design. Through analyzing the design requirements of the human balanced function testing equipment, this paper develop a balanced apparatus to meet the research needs and establish the alternative evaluation index set of balance function.
2. The first filter of repetitive analysis of the balance testing index. This paper selects a few people to repeat the test which is in order to verify the repeatability balance test system of the human being. By repetitive statistical validation, a large number of test targets on a preliminary screening, good indexes of reproducibility are retained and bigger changes of the larger indexes are excluded.
3. The second filter based on the trend map of age-balance testing index. The map of the age changed of different indexes is drawn based on the initial filter of the balance function index. The messy indexes of changed age are removed and the stronger indexes are retained. The best age group is selected from the relationship between the balance function and the age. Analyze the relationship between the age and index of each people who is more than the best crowd. And sort the related coefficient based on size. The second filter of the balanced evaluation index is completed based the proposed system analysis.
4. The third filter of the principal component analysis on the balance testing index. Based on the second filter, the principal analysis is done to the entire crowd. And the key index is selected by the variance of different indexes which are sorted.
5. Establish the scoring criterion. Based on the evaluation index system, the age distribution map of different indexes is drawn. The criterion is established according to the number of principal component analysis of factor and the variance and standard deviations of the key index.
引文
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陈海霞,宁宁.2006.人体平衡功能评定研究的最新进展.现代护理,12(23):2173-2175.
张素珍,赵承君.2006.静态平衡功能定量分析.中华耳科学杂志,4(4):258-261.
张盘德,彭小文,皮周凯,等.2004.人体平衡功能检测系列研究( 1):正常人静态姿势平衡的定量评定及性别、年龄的差异.中国康复理论与实践,10(7):414-417.
彭小文,张盘德,张自茂,等.2005.人体平衡功能检测系列研究( 2 ):正常人静态平衡的正常参考值范围及相关因素.中国康复理论与实践,11(8):644-646.
徐本华,谢斌,黄永禧.2003.正常人静态平衡姿势图影响因素的研究.中华物理医学与康复杂志,25(6):340-243.
杨志金.2008.康复医学中平衡功能评定研究.重庆医学,37(17):1993-1995.
张丽,翁长水,王秋华,等.2010.前庭感觉、本体感觉及视觉功能对老年人跌倒风险影响的因素分析.中国康复理论与实践,16(1):16-18.
付丽敏,崔景辉,冯巨涛.2010.性别与年龄对儿童静态平衡功能影响的定量对比分析.中国康复医学杂志,25(3):251-254.
杨志金,尹志勇,舒彬,等.2009.便携式人体平衡测试仪的信度及敏感性研究.中国康复, 24(3):156-158.
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