Medeiros Italo R T, Bittar Roseli S M, Pedalini Maria Elisabete B, Lorenzi Maria Cecília, Formigoni Lázaro G, Bento Ricardo F
Department of Otorhinolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Otol Neurotol. 2005 Jul;26(4):699-703. doi: 10.1097/01.mao.0000169051.69254.85.
Vestibular disturbances are underdiagnosed in children. However, balance impairment may compromise the normal development of affected children. The appropriate therapeutic approach has not been agreed on for this age group. Vestibular rehabilitation therapy has excellent results in adults, but very few data exist regarding its results in children. We evaluated through clinical assessment and computerized dynamic posturography the outcome of children with peripheral vestibular disturbances undergoing vestibular rehabilitation therapy and observed the influence of learning and of central nervous system maturation on posturography retest results.
Sixteen children (10 boys and 6 girls) with peripheral vestibular disorders (mean age, 8 yr 7 mo) constituted the cohort and were consecutively treated with vestibular rehabilitation therapy. Symptomatic children underwent pre- and posttreatment computerized dynamic posturography. Their outcome was clinically assessed. Another 16 asymptomatic children, paired by sex and age, underwent two computerized dynamic posturography procedures with the same time interval as that of the symptomatic group.
All children completed the treatment. Total recovery of symptoms occurred in nine (56.3%) patients, whereas a dramatic partial recovery was observed in the remaining seven (43.7%) children. Posturography Conditions 5 and 6, the vestibular ratio of the sensory analysis, and the composite equilibrium score had a significant quantitative improvement after vestibular rehabilitation therapy. No adverse reactions occurred to the exercises. No statistically significant posturography changes were observed in the asymptomatic children.
Vestibular rehabilitation therapy seems to be a safe and efficacious therapeutic option in children with peripheral vestibular disturbances.
儿童前庭功能障碍的诊断不足。然而，平衡功能受损可能会影响患病儿童的正常发育。对于这个年龄组，尚未就适当的治疗方法达成共识。前庭康复治疗在成人中效果良好，但关于其在儿童中的效果的数据却很少。我们通过临床评估和计算机化动态姿势描记法评估了接受前庭康复治疗的外周前庭功能障碍儿童的治疗效果，并观察了学习和中枢神经系统成熟对姿势描记法复测结果的影响。
16名患有外周前庭疾病的儿童（10名男孩和6名女孩，平均年龄8岁7个月）组成了该队列，并连续接受前庭康复治疗。有症状的儿童在治疗前和治疗后进行了计算机化动态姿势描记法检查。对他们的治疗效果进行了临床评估。另外16名无症状儿童，按性别和年龄配对，进行了两次计算机化动态姿势描记法检查，时间间隔与有症状组相同。
所有儿童均完成了治疗。9名（56.3%）患者症状完全恢复，而其余7名（43.7%）儿童有显著的部分恢复。姿势描记法条件5和6、感觉分析的前庭比率以及综合平衡评分在前庭康复治疗后有显著的定量改善。锻炼未出现不良反应。无症状儿童未观察到姿势描记法有统计学意义的变化。
前庭康复治疗似乎是外周前庭功能障碍儿童的一种安全有效的治疗选择。
