Hansson Eva Ekvall, Månsson Nils-Ove, Ringsberg Karin A, Håkansson Anders
Department of Clinical Sciences in Malmö, Lund University, Family Medicine, Malmö University Hospital, Malmö, Sweden.
Int J Rehabil Res. 2008 Mar;31(1):51-7. doi: 10.1097/MRR.0b013e3282f28e2c.
The objective of this study is to investigate whether vestibular rehabilitation can improve balance, reduce self-perceived handicap because of dizziness and, if possible, reduce falls among dizzy patients in primary healthcare. The study also finds out which of the balance measures and measure of self-perceived handicap, if any, predicted the risk of falls. The design of this study is an intervention study with control group. Fifty-eight patients, 65 years and older, with multisensory dizziness were taken as participants. The intervention group trained vestibular rehabilitation twice a week for 9 weeks. All patients were assessed at baseline and after 3 months, with four different balance measures and the Dizziness Handicap Inventory. After 6, 9 and 12 months, a follow-up by telephone was performed and, at 12 months, the patients also filled out a Dizziness Handicap Inventory questionnaire. Statistically significant differences were found between the groups between baseline and 3 months in one static balance measure and in one dynamic measure (P=0.038 and 0.044). In total, 40 falls were reported, 31 were classified as intrinsic falls, 26 of them caused by vertigo and nine falls were classified as extrinsic. No difference was found between the two groups in proportions of patients who fell. Poor ability to stand in tandem stance doubled the risk for falls. Vestibular rehabilitation can improve balance in elderly patients with multisensory dizziness. Vertigo is a common cause of falls in this group of patients and vestibular rehabilitation is a feasible treatment.
本研究的目的是调查前庭康复是否可以改善平衡能力,减少因头晕导致的自我感知障碍,并且如果可能的话,降低基层医疗中头晕患者的跌倒发生率。该研究还找出了哪些平衡测量指标和自我感知障碍测量指标(如果有的话)能够预测跌倒风险。本研究的设计是一项有对照组的干预性研究。选取了58名65岁及以上患有多感官头晕的患者作为参与者。干预组每周进行两次前庭康复训练,共9周。所有患者在基线时和3个月后均接受了四项不同的平衡测量指标和头晕残障量表评估。在6个月、9个月和12个月后进行电话随访,并且在12个月时,患者还填写了一份头晕残障量表问卷。在基线和3个月之间,两组在一项静态平衡测量指标和一项动态测量指标上存在统计学显著差异(P = 0.038和0.044)。总共报告了40次跌倒,其中31次被归类为内在性跌倒,其中26次由眩晕引起,9次跌倒被归类为外在性跌倒。两组之间跌倒患者的比例没有差异。前后串联站立能力差会使跌倒风险增加一倍。前庭康复可以改善患有多感官头晕的老年患者的平衡能力。眩晕是该组患者跌倒的常见原因,前庭康复是一种可行的治疗方法。