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[用于头晕和平衡障碍患者治疗与康复的计算机化方法]

[Computerized methods for therapy and rehabilitation of patients suffering dizziness and balance disorder].

作者信息

Kornilova L N, Temnikova V V, Naumov I A, Ekimovskiĭ G A, Solov'eva A D

出版信息

Fiziol Cheloveka. 2010 Nov-Dec;36(6):113-21.

Abstract

A new computerized method is proposed for correction and inhibition of unfavorable illusory (vertigo), vestibular-oculomotor (nystagmus), and vestibular-postural (balance) responses. This method allows to teach the subject to block generalization of an afferent signal to effector mechanisms of the central nervous system by developing a fixational reflex, utilizing a delayed biofeedback. Three variant ofthis method were employed, depending on the kind of stimulation programs aimed at inducing abnormal responses of a certain sensory modality (visual, vestibular or combined). The study involved 36 subjects divided into 3 equal groups one of which had been taught by a visual or vestibular technique, and the last one by a combined. Each group included approximately equal numbers of subjects with vestibulopathies of an organic (peripheral or central) or psychogenic origin. It was demonstrated that the method proposed allows, with the help of computerized stimulation programs, to provoce abnormal illusory and vestibular-optooculomotor responses in the subject, and inhibit them with the help of development of a fixational reflex. Patients were taught using three various variants of the method. A subsequent comparative analysis of results obtained has shown dependence of their effectiveness on the level of disturbance in the vestibular system: the visual variant of correction was the most effective for subjects with peripheral vestibulopathia; for subjects with central vestibulopathia, the vestibular variant was more effective; the combined variant of correction was the most effective for subjects with psychogenic vestibulopathia.

摘要

本文提出了一种新的计算机化方法,用于校正和抑制不良的幻觉(眩晕)、前庭眼动(眼球震颤)和前庭姿势(平衡)反应。该方法通过利用延迟生物反馈建立注视反射,使受试者学会阻断传入信号向中枢神经系统效应器机制的泛化。根据旨在诱发特定感觉模态(视觉、前庭或联合)异常反应的刺激程序类型,采用了该方法的三种变体。该研究涉及36名受试者,分为3个相等的组,其中一组采用视觉或前庭技术进行训练,最后一组采用联合技术进行训练。每个组中患有器质性(外周或中枢)或心因性前庭病变的受试者数量大致相等。结果表明,所提出的方法借助计算机化刺激程序,能够在受试者中诱发异常的幻觉和前庭视眼动反应,并通过建立注视反射来抑制这些反应。使用该方法的三种不同变体对患者进行了训练。随后对所得结果的比较分析表明,其有效性取决于前庭系统的紊乱程度:视觉校正变体对患有外周前庭病变的受试者最有效;对于患有中枢前庭病变的受试者,前庭变体更有效;联合校正变体对患有心因性前庭病变的受试者最有效。

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