McGibbon Chris A, Krebs David E, Wolf Steven L, Wayne Peter M, Scarborough Donna Moxley, Parker Stephen W
Institute of Biomedical Engineering, and Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada E3B 5A3.
J Vestib Res. 2004;14(6):467-78.
Tai Chi (TC) is a comparatively new intervention for peripheral vestibular hypofunction, which is often treated with vestibular rehabilitation (VR). We compared gaze stability (GZS), whole-body stability (WBS) and footfall stability (FFS) during locomotion among 26 people with vestibulopathy (VSP), randomized into two treatment arms (13 TC and 13 VR). Each intervention program was offered for 10 weeks. GZS improved more for VR than for TC, but WBS (and FFS) improved more for TC than for VR. There was a significant relationship between changes in GZS and WBS for the VR subjects (r=0.60, p=0.01), but not for TC subjects. There was a significant relationship between changes in WBS and FFS for both VR (r=0.65, p <0.01) and TC (r=0.58, p=0.02) groups; the relationship disappeared in the VR but not the TC group when controlling for GZS. These findings suggest that VR and TC both benefit patients with VSP but via differing mechanisms. Moreover, these data are the first to test the assumption that improving gaze control among patients with VSP perforce improves postural stability: it does not. We conclude that GZS is most improved in those who receive VR, but that TC improves WBS and FFS without improving GZS, suggesting patients with VSP can rely on non-gaze related mechanisms to improve postural control.
太极拳（TC）是一种针对外周前庭功能减退的相对较新的干预措施，外周前庭功能减退通常采用前庭康复训练（VR）进行治疗。我们比较了26名前庭病（VSP）患者在运动过程中的凝视稳定性（GZS）、全身稳定性（WBS）和步幅稳定性（FFS），这些患者被随机分为两个治疗组（13名接受太极拳治疗和13名接受前庭康复训练）。每个干预方案持续10周。前庭康复训练组的凝视稳定性改善程度高于太极拳组，但太极拳组的全身稳定性（和步幅稳定性）改善程度高于前庭康复训练组。在前庭康复训练组受试者中，凝视稳定性变化与全身稳定性变化之间存在显著相关性（r = 0.60，p = 0.01），而太极拳组受试者则不存在这种相关性。在前庭康复训练组（r = 0.65，p <0.01）和太极拳组（r = 0.58，p = 0.02）中，全身稳定性变化与步幅稳定性变化之间均存在显著相关性；在控制凝视稳定性后，这种相关性在前庭康复训练组中消失，但在太极拳组中未消失。这些发现表明，前庭康复训练和太极拳对前庭病患者均有益，但作用机制不同。此外，这些数据首次检验了以下假设：改善前庭病患者的凝视控制必然会改善姿势稳定性，但实际并非如此。我们得出结论，接受前庭康复训练的患者凝视稳定性改善最为明显，但太极拳可改善全身稳定性和步幅稳定性，而不改善凝视稳定性，这表明前庭病患者可以依靠与凝视无关的机制来改善姿势控制。
