Postural disorders in patients with vibration disease

Abstract

Introduction. Vibration disease (VD) is one of the leading occupational diseases. One of the manifestations of this disease when exposed to general vibration may be a violation of balance.The aim of the study is to identify the imbalance and the causes of their occurrence in patients with vibration disease.Materials and methods. 3 groups of patients were examined. The first group consisted of 50 patients diagnosed with VD associated with combined exposure to local and general vibration (age 48.7±3.1 years); the second group consisted of 50 patients diagnosed with VD associated with exposure to local vibration (age 48.9+2.8 years); the control group consisted of 50 relatively healthy men not in contact with vibration (age 49.1+2.5 years). Survey on electronic stabilometer ST–150 (Biomera, Russia). Patients performed the Romberg test standing barefoot vertically on a stabilometric platform with a “European” stop position. Statistical processing of the results was carried out using the software package “Statistica 10.0” (StatSof, USA, 2011). Methods of descriptive statistics included estimation of median, lower and upper quartiles. The statistical significance of the differences was determined using the nonparametric Wilkinson method. Differences were considered statistically significant at p<0.05.Results. In the analysis of the obtained stabilometric parameters found that in the first group of patients marked imbalance.Moreover, in comparison with the second group and the control group in the phase with eyes closed, patients are more difficult to maintain a given posture, which increases the length of statokinesigram (p=0.02 and p=0.005), increasing the speed of movement of the center of pressure (p=0.03 and p=0.004) and the square of the deviation of the center of pressure (p=0.03 and p=0.004). When closing the eyes, patients put more effort to maintain balance, which affects the rate of mechanical work (p=0.001 and p=0.001). When comparing the second group with the control group, no statistically significant difference was found in the main stabilometric indicators.Conclusions: In the group of patients with VD associated with the combined effects of local and general vibration, marked (64%) and moderate (36%) postural disorders, especially in the phase of closed eyes. In the group of patients with VS associated with local vibration exposure and in the control group, imbalance was detected in 10% and 6%, respectively. The leading role in the occurrence of postural disorders in patients with VD, associated with the combined effects of local and general vibration, plays the formation of a focus of stagnant excitation in the centers of vibration sensitivity. In the future, the pulse can spread to nearby centers of pain, temperature sensitivity and proprioception, which contributes to the emergence of lower limb polyneuropathy and impaired stability in patients with vibration disease.