Herdman Susan J, Schubert Michael C, Das Vallabh E, Tusa Ronald J
Department of Rehabilitation Medicine, Emory University, Atlanta, Ga., USA.
Arch Otolaryngol Head Neck Surg. 2003 Aug;129(8):819-24. doi: 10.1001/archotol.129.8.819.
To determine the effect of vestibular exercises on the recovery of visual acuity during head movement in patients with unilateral vestibular hypofunction.
Prospective, randomized, double-blind study.
Ambulatory referral center.
Twenty-one patients with unilateral vestibular hypofunction, aged 20 to 86 years.
One group (13 patients) performed vestibular exercises designed to enhance the vestibulo-ocular reflex, and the other group (8 patients) performed placebo exercises. The placebo group was switched to vestibular exercises after 4 weeks.
Measurements of dynamic visual acuity (DVA) during predictable (DVA-predictable) and unpredictable (DVA-unpredictable) head movements by means of a computerized test and measurement of intensity of oscillopsia by means of a visual analog scale.
As a group, patients who performed vestibular exercises showed a significant improvement in DVA-predictable (P<.001) and DVA-unpredictable (P<.001), while those performing placebo exercises did not (P =.07). On the basis of stepwise regression analysis, the leading factor contributing to improvement was vestibular exercises. This reached significance for DVA-predictable (P =.009) but not DVA-unpredictable (P =.11). Other factors examined included age, time from onset, initial DVA, oscillopsia, and duration of treatment. Changes in oscillopsia did not correlate with DVA-predictable or DVA-unpredictable.
Use of vestibular exercises is the main factor involved in recovery of DVA-predictable and DVA-unpredictable in patients with unilateral vestibular hypofunction. Exercises may foster the use of centrally programmed eye movements that could substitute for the vestibulo-ocular reflex. The DVA-predictable would benefit more from this than would DVA-unpredictable.
确定前庭锻炼对单侧前庭功能减退患者头部运动时视力恢复的影响。
前瞻性、随机、双盲研究。
门诊转诊中心。
21例单侧前庭功能减退患者，年龄20至86岁。
一组（13例患者）进行旨在增强前庭眼反射的前庭锻炼，另一组（8例患者）进行安慰剂锻炼。安慰剂组在4周后改为前庭锻炼。
通过计算机测试测量可预测（可预测动态视力，DVA-predictable）和不可预测（不可预测动态视力，DVA-unpredictable）头部运动时的动态视力，并通过视觉模拟量表测量视振荡强度。
总体而言，进行前庭锻炼的患者在可预测动态视力（P<0.001）和不可预测动态视力（P<0.001）方面有显著改善，而进行安慰剂锻炼的患者则没有（P = 0.07）。基于逐步回归分析，改善的主要因素是前庭锻炼。这在可预测动态视力方面达到显著水平（P = 0.009），但在不可预测动态视力方面未达到显著水平（P = 0.11）。检查的其他因素包括年龄、发病时间、初始动态视力、视振荡和治疗持续时间。视振荡的变化与可预测动态视力或不可预测动态视力均无相关性。
在前庭功能减退患者中，使用前庭锻炼是可预测动态视力和不可预测动态视力恢复的主要因素。锻炼可能促进使用中枢编程的眼球运动，以替代前庭眼反射。可预测动态视力比不可预测动态视力从这方面获益更多。
