Résumé
La posturographie, c’est-à-dire l’évaluation de l’équilibre à partir des modifications du centre des pressions recueillies par une plateforme de forces, s’est développée depuis 40 ans environ. Au cours des dernières années, des perfectionnements ont été proposés tant dans le domaine des conditions d’exploration (appui unipodal, limites de stabilité, posturographie dynamique) que d’analyse du signal (analyse non linéaire). Si la posturographie constitue le moyen le plus adapté à l’évaluation de la station debout, sa place dans l’évaluation des troubles de l’équilibre reste discutée. Plusieurs raisons constituent un frein à son utilisation. En effet, au-delà du coût d’acquisition, de réalisation et d’interprétation des résultats, plusieurs auteurs ont rapporté les interrogations portant sur la reproductibilité des examens, leur sensibilité, leur spécificité et leur intérêt vis-à-vis d’autres explorations cliniques ou instrumentales en fonction des pathologies considérées. Ce sont ces éléments qui seront abordés ici en sachant que des évolutions sont sans cesse proposées dans ce domaine qui voit croître régulièrement le nombre de publications qui lui sont consacrées.
Abstract
Posturography, i.e. the assessment of balance based on modifications to the pressure centre collected by a force platform, has seen many developments over the last forty years. Recently, improvements have been proposed in the area of experimental conditions (single-leg balancing, limits of stability, dynamic posturography) and also to signal analysis (non-linear analysis). Even if posturography is the most suitable means for assessing the upright position, its place in the evaluation of balance problems remains under discussion. There are many reasons why its use has not been widely accepted. Indeed, aside from the initial purchase cost and the collecting and interpretation of results, many authors have called into question the reproducibility of the tests, their sensitivity, their specificity and their interest with regard to other clinical or instrumental examinations for certain diseases. These are the elements that will be tackled here, with the understanding that developments are constantly being put forward in this area, that will see a regular increase in the number of publications on this subject.
Références
Bizzo G, Guillet N, Patat A, Gagey PM (1985) Specifications for building a vertical force-platform designed for clinical stabilometry. Med Biol Eng Comput 23:474–476
Amblard B (1998) Les descripteurs du contrôle postural. Ann Readapt Med Phys 41:225–237
Collins JJ, De Luca CJ (1995) The effects of visual input on open-loop and closed-loop postural control mechanisms. Exp Brain Res 103:151–163
Rougier P, Caron O (2000) Center of gravity motions and ankle joint stiffness control in upright undisturbed stance modeled through a fractional Brownian motion framework. J Mot Behav 32:405–413
Tropp H, Odenrick P, Gillquist J (1985) Stabilometry recordings in functional and mechanical instability of the ankle joint. Int J Sports Med 6:180–182
Gauffin H, Tropp H, Odenrick P (1988) Effect of ankle disk training on postural control in patients with functional instability of the ankle joint. Int J Sports Med 9:141–144
Schieppati M, Hugon M, Grasso M, et al (1994) The limits of equilibrium in young and elderly normal subjects and in parkinsonians. Electroencephalogr Clin Neurophysiol 93:286–298
Nashner LM, Peters JF (1990) Dynamic posturography in the diagnosis and management of dizziness and balance disorders. Neurol Clin 8:331–349
Geurts AC, Nienhuis B, Mulder TW (1993) Intrasubject variability of selected force-platform parameters in the quantification of postural control. Arch Phys Med Rehabil 74:1144–1150
Pinsault N, Vuillerme N (2009) Test-retest reliability of centre of foot pressure measures to assess postural control during unperturbed stance. Med Eng Phys 31:276–286
Horak FB, Nashner LM, Diener HC (1990) Postural strategies associated with somatosensory and vestibular loss. Exp Brain Res 82:167–177
Mbongo F, Tran Ba Huy P, Vidal PP, de Waele C (2007) Relationship between dynamic balance and self-reported handicap in patients who have unilateral peripheral vestibular loss. Otol Neurotol 28:905–910
Owings TM, Pavol MJ, Foley KT, Grabiner MD (2000) Measures of postural stability are not predictors of recovery from large postural disturbances in healthy olders adults. J Am Geriatr Soc 48:42–50
Ebersbach G, Gunkel M (2011) Posturography reflects clinical imbalance in Parkinson’s disease. Mov Disord 26:241–246
Missaoui B, Thoumie P (2009) How far do patients with sensory ataxia benefit from so-called “proprioceptive rehabilitation”? Neurophysiol Clin 39:229–233
Pérennou D, Decavel P, Manckoundia P, et al (2005) Evaluation of balance in neurologic and geriatric disorders. Ann Readapt Med Phys 48:317–335
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Thoumie, P. Intérêts et limites de la posturographie pour l’évaluation des troubles de l’équilibre. Lett Med Phys Readapt 28, 139–144 (2012). https://doi.org/10.1007/s11659-012-0300-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11659-012-0300-9