Test-retest reliability of subjective visual vertical from different head-tilt angles in young healthy adults
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摘要: 目的 建立不同头位偏斜角度下的主观视觉垂直线(subjective visual vertical，SVV)正常值数据，并分析其复测信度，为SVV的临床应用提供参考。方法 选取31名健康青年人，佩戴虚拟现实眼镜，分别测试在直立头位0°、左头位偏斜45°(L45°)、右头位偏斜45°(R45°)、左头位偏斜90°(L90°)、右头位偏斜90°(R90°)5个不同角度下的SVV数据，并于2周后进行复测。结果 ① 0°、L45°、R45°、L90°、R90° 5个不同头位偏斜角度下的SVV平均值分别为：-0.07±1.71、4.30±5.39、-6.51±5.58、-3.76±7.42、0.40±8.02，95%CI分别为：(-3.42，3.28)、(-6.26，14.86)、(-17.45，4.43)、(-18.30，10.78)、(-15.32，16.12)；②L45°、R45°、L90°、R90°4个不同头位偏斜角度下的SVV偏差绝对值分别为：5.62±3.96、6.90±5.07、6.82±4.70、6.48±4.68；95%CI分别为：(0，12.11)、(0，15.21)、(0，14.53)、(0，14.16)；双侧45°偏差绝对值的不对称性比为10%；双侧90°偏差绝对值的不对称性比为3%；③0°、L45°、R45°、L90°、R90° SVV的组内相关系数分别为0.757、0.673、0.674、0.815、0.856。结论 SVV具有良好的复测信度，临床测试稳定性高，本研究建立的不同偏斜角度下SVV正常值数据可辅助临床对前庭系统疾病进行精细化诊断和功能评估。Abstract: Objective To establish the normal values of subjective visual vertical (SVV) in different head deflection angles and analyze its test and retest reliability, in order to provide a reference for the clinical application of SVV in the evaluation of vestibular disorders.Methods Thirty-one healthy young people were selected to wear VR glasses, and the SVV data were tested in five different head-tilt, namely, 0° in the upright head position, 45°in the left head position, 45° in the right head position, 90° in the left head position, and 90° in the right head position, and were re-tested 2 weeks later.Results ① The mean values of SVV at 5 different head-tilt angles of 0°, left 45°, right 45°, left 90°, and right 90° were -0.07±1.71, 4.30±5.39, -6.51±5.58, -3.76±7.42, and 0.40±8.02, respectively, The 95% confidence limits of SVV at 0°, left 45°, right 45°, left 90°, right 90°, and right 90° were (-3.42, 3.28), (-6.26, 14.86), (-17.45, 4.43), (-18.30, 10.78), and(-15.32, 16.12), respectively; ②The absolute values of SVV at 4 different head-tilt angles of left 45°, right 45°, left 90°, and right 90° were 5.62±3.96, 6.90±5.07, 6.82±4.70 and 6.48±4.68, respectively. The 95% confidence limits of SVV at left 45°, right 45°, left 90°, right 90°, and right 90° were(0, 12.11), (0, 15.21), (0, 14.53)and(0, 14.16), respectively. The asymmetry ratio is 10% for the absolute value of the 45 ° deviation and 3% for the absolute value of the 90° deviation; ③Intra-class correlation coefficients(ICC) for 0°, left 45°, right 45°, left 90°, right 90°were 0.757, 0.673, 0.674, 0.815, and 0.856, respectively.Conclusion SVV has good retest reliability and high stability, and the SVV normal value data of different head deviation angles established in the present study can be used as a reference for the diagnosis and evaluation of vestibular disorders.
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表 1 不同头位偏斜角度下SVV正常值及95%CI
头位 Mean SD 95%CI 0 -0.07 1.71 (-3.42，3.28) L45° 4.30 5.39 (-6.26，14.86) R45° -6.51 5.58 (-17.45，4.43) L90° -3.76 7.42 (-18.30，10.78) R90° 0.40 8.02 (-15.32，16.12) 
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表 2 SVV双侧不对称性比较
头位 绝对值均值 绝对值标准差 绝对值95%CI 不对称比/% t P L45° 5.62 3.96 (0，12.11) 10.0 -1.563 0.121 R45° 6.90 5.07 (0，15.21) L90° 6.82 4.70 (0，14.53) 3.0 0.414 0.680 R90° 6.48 4.68 (0，14.16)
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表 3 2组不同头位偏斜角度下的SVV复测信度
头位 r ICC 95%CI P 0° 0.779 0.757 (0.540，0.877) < 0.001 L45° 0.726 0.673 (0.380，0.836) < 0.001 R45° 0.669 0.674 (0.423，0.829) < 0.001 L90° 0.826 0.815 (0.649，0.907) < 0.001 R90° 0.854 0.856 (0.722，0.928) < 0.001
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