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Intérêt et limites des tests cliniques et des échelles ordinales pour l’évaluation de l’équilibre

Interest and limitations of clinical tests and numerical scales in the evaluation of balance

  • Article de Synthèse / Review Article
  • Published:
La Lettre de médecine physique et de réadaptation

Résumé

L’examen clinique d’un patient présentant un trouble de l’équilibre doit permettre d’aborder et de répondre en partie à trois questions: quelles en sont la ou les causes ? Quelle en est la sévérité ? Quelle en est l’évolution ? L’interrogatoire tient une place essentielle dans l’évaluation du retentissement physique, psychique et social. L’examen est conduit méthodiquement afin de noter les difficultés d’équilibre du patient avec des données chiffrées qui permettront de suivre l’évolution selon les traitements et la rééducation avec le plus d’objectivité possible. De nombreux tests, scores et échelles ont été construits, génériques ou spécifiques de certaines pathologies. Ils sont très utiles, notamment pour comparer les patients entre eux, mais n’ont pas toujours une grande solidité métrologique, et leur valeur prédictive est très faible. En outre, ils ne reproduisent pas les conditions naturelles et ne sont qu’un reflet partiel de la réalité.

Abstract

The clinical examination of a patient presenting with a balance disorder should, in part, address and answer the following three questions: What is or are the causes? How severe is it? What changes have there been? The interview plays an essential role in the evaluation of the physical, psychological and social implications of the disorder. The examination is methodically carried out, noting the patient’s balance issues using a numerical system, which allows progress to be monitored, as objectively as possible, based on the treatment and rehabilitation received. Numerous tests, scores and scales have been designed, which are either generic or specific to certain diseases. They are very useful, especially when it comes to comparing patients, but they do not always use particularly reliable instrumentation and their predictive value is generally very poor. Moreover, they do not reproduce normal conditions, and therefore only partially reflect reality.

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  1. Service de médecine physique et de réadaptation, groupe hospitalier St-Louis-Lariboisière-F.-Widal, AP-HP, université Paris-Diderot, 200, rue du Faubourg-St-Denis, F-75010, Paris, France

    A. Yelnik

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  1. A. Yelnik
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Yelnik, A. Intérêt et limites des tests cliniques et des échelles ordinales pour l’évaluation de l’équilibre. Lett Med Phys Readapt 28, 133–138 (2012). https://doi.org/10.1007/s11659-012-0301-8

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  • DOI: https://doi.org/10.1007/s11659-012-0301-8

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