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[用于眩晕和平衡障碍患者治疗与康复的计算机辅助技术]

[Computer-aided techniques for the treatment and rehabilitation of patients suffering vertigo and balance disorders].

作者信息

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

出版信息

Vestn Otorinolaringol. 2010(6):38-43.

Abstract

A new computerized method is proposed for the correction and elimination of undesirable illusory sensations (dizziness), vestibulo-oculomotor (nystagmus), and vestibulo-postural (imbalance) reactions. The method allows to teach the subject about how to avoid generalization of afferent signals over the effector mechanisms in the central nervous system by developing a fixational reflex employing delayed biological feedback for the assessment of efforts being exerted (self-control of training results). Three variants of application of this technique were evaluated depending on the type of stimulation software intended to induce illusory and oculomotor reactions of a defined sensory modality (visual, vestibular or combined). The study involved 30 subjects divided into three groups. They had been taught using the visual (group 1), vestibular (group 2) or combined (group 3) methods. Each group was comprised of an approximately equal number of subjects with vestibulopathies of either peripheral or central origin. The study demonstrated that the proposed approach allows to invoke, with the use of a computer stimulation software, abnormal illusory and vestibulo-oculomotor responses and inhibit them by developing the adequate fixational reflex. Comparative analysis of the results obtained by teaching the patients with the help of the three different methods revealed the dependence of their effectiveness on the level of disturbances in the vestibular system. The visual method of correction proved to be especially efficacious for the patients with peripheral vestibulopathy, and the vestibular methods for the patients with central vestibulopathy. Patients with combined peripheral and central vestibulopathy required the choice of training modalities (either visual or vestibular) on an individual basis.

摘要

本文提出了一种新的计算机化方法,用于纠正和消除不良的虚幻感觉(头晕)、前庭眼动(眼球震颤)和前庭姿势(失衡)反应。该方法通过利用延迟生物反馈来评估所施加的努力(训练结果的自我控制),从而建立注视反射,使受试者学会如何避免中枢神经系统中传入信号在前效应器机制上的泛化。根据旨在诱发特定感觉模态(视觉、前庭或联合)的虚幻和眼动反应的刺激软件类型,评估了该技术的三种应用变体。该研究涉及30名受试者,分为三组。他们分别采用视觉(第1组)、前庭(第2组)或联合(第3组)方法进行训练。每组中患有外周性或中枢性前庭病变的受试者数量大致相等。研究表明,所提出的方法能够通过计算机刺激软件诱发异常的虚幻和前庭眼动反应,并通过建立适当的注视反射来抑制这些反应。对采用三种不同方法对患者进行训练所获得的结果进行比较分析后发现,其有效性取决于前庭系统的紊乱程度。矫正的视觉方法对患有外周性前庭病变的患者特别有效,而前庭方法对患有中枢性前庭病变的患者有效。患有外周和中枢联合性前庭病变的患者需要根据个体情况选择训练方式(视觉或前庭)。

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