Emory University School of Medicine, Atlanta, GA, USA.
Neurorehabil Neural Repair. 2012 Feb;26(2):151-62. doi: 10.1177/1545968311407514. Epub 2011 Sep 29.
Not all individuals with unilateral vestibular hypofunction (UVH) have fewer subjective complaints and improved function after vestibular rehabilitation.
To identify factors and/or combinations of factors that are strongly associated with rehabilitation outcome in patients with UVH and that ultimately can be used to develop models to predict outcome.
Data from 209 patients with UVH were analyzed. All patients participated in similar vestibular rehabilitation (5 weeks of home exercises and once-weekly clinic visits). Outcome measures included intensity of oscillopsia and dysequilibrium, balance confidence, perceived disability, percentage of time symptoms interfered with activities, gait speed, fall risk, and dynamic visual acuity (DVA). Bivariate correlation and regression analysis were used to determine relationships between baseline (pretherapy) measures and outcome at discharge.
No baseline measure of subjective complaints (eg, symptom intensity) predicted improvement of physical function (eg, gait speed). Similarly, no baseline measure of physical function predicted improvement of subjective complaints. Certain patient characteristics, such as gender and time from onset, were not related to any outcomes. Most comorbidities did not affect outcome; however, anxiety and/or depression were associated with lower balance confidence and higher percentage of time for which symptoms interfered with activities at discharge. Baseline DVA and gait speed were associated with DVA and gait speed at discharge, respectively. Dynamic gait index (DGI) at discharge was affected by age, baseline DGI, and history of falls.
These results provide insight into recovery of patients with UVH. Therapists can use this information in the development of expectations for patient outcome and treatment priorities.
并非所有单侧前庭功能低下（UVH）患者在进行前庭康复后主观症状减少和功能改善。
确定与 UVH 患者康复结果密切相关的因素和/或因素组合，并最终用于开发预测结果的模型。
分析了 209 例单侧前庭功能低下患者的数据。所有患者均接受了类似的前庭康复治疗（5 周家庭锻炼和每周一次的诊所就诊）。结果评估包括眼球震颤和平衡障碍的强度、平衡信心、感知障碍、症状干扰活动的时间百分比、步态速度、跌倒风险和动态视力（DVA）。采用双变量相关和回归分析来确定基线（治疗前）测量值与出院时的结果之间的关系。
没有任何基线主观症状（例如症状强度）测量值可以预测身体功能（例如步态速度）的改善。同样，没有任何基线身体功能测量值可以预测主观症状的改善。某些患者特征，如性别和发病时间，与任何结果均无关。大多数合并症对结果没有影响；然而，焦虑和/或抑郁与较低的平衡信心和更高的症状干扰活动时间百分比相关。基线 DVA 和步态速度分别与出院时的 DVA 和步态速度相关。出院时的动态步态指数（DGI）受年龄、基线 DGI 和跌倒史的影响。
这些结果提供了对单侧前庭功能低下患者康复的深入了解。治疗师可以在制定患者结果和治疗重点的预期时使用这些信息。
