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振动触觉神经反馈训练在站立和行走条件下治疗平衡缺陷的疗效:一项双盲、安慰剂对照的多中心研究。

Efficacy of a vibrotactile neurofeedback training in stance and gait conditions for the treatment of balance deficits: a double-blind, placebo-controlled multicenter study.

机构信息

Department of Otolaryngology at UKB, Hospital of University of Berlin, Charité Medical School, Berlin, Germany.

出版信息

Otol Neurotol. 2011 Dec;32(9):1492-9. doi: 10.1097/MAO.0b013e31823827ec.

Abstract

OBJECTIVE

Vestibular rehabilitation strategies mostly require a long-lasting training in stance conditions, which is finally not always successful. The individualized training in everyday-life conditions with an intuitive tactile neurofeedback stimulus seems to be a more promising approach. Hence, the present study was aimed at investigating the efficacy of a new vibrotactile neurofeedback system for vestibular rehabilitation.

STUDY DESIGN

Double-blinded trial.

PATIENTS

One hundred five patients who experience one of the following balance disorders for more than 12 months were included in the study: canal paresis, otolith disorder, removal of an acoustic neuroma, microvascular compression syndrome, Parkinson's disease, and presbyvertigo.

INTERVENTIONS

Vibrotactile neurofeedback training was performed daily (15 min) over 2 weeks with the Vertiguard system in those 6 tasks of the Standard Balance Deficit Test with the most prominent deviations from the normative values.

MAIN OUTCOME MEASURES

Trunk and ankle sway, dizziness handicap inventory, and vestibular symptom score were measured in the verum and placebo group before the training, on the last training day and 3 months later.

RESULTS

A significant reduction in trunk and ankle sway as well as in the subjective symptom scores were observed in the verum group. Such an effect could not be found in any of the outcome parameters of the placebo group.

CONCLUSION

The vibrotactile neurofeedback training applied in the present study is a highly efficient method for the reduction of body sway in different balance disorders. Because the rehabilitation program is easy to perform, not exhausting, and time saving, elderly patients and those with serious, long-lasting balance problems also can participate successfully.

摘要

目的

前庭康复策略大多需要在站立条件下进行长期训练,但最终并非总是成功。在日常生活条件下进行个体化训练,并使用直观的触觉神经反馈刺激,似乎是一种更有前途的方法。因此,本研究旨在探讨一种新的振动触觉神经反馈系统在前庭康复中的疗效。

研究设计

双盲试验。

患者

105 名患有以下平衡障碍之一超过 12 个月的患者纳入本研究:半规管麻痹、耳石症、听神经瘤切除、微血管压迫综合征、帕金森病和老年性眩晕。

干预措施

使用 Vertiguard 系统,在标准平衡缺陷测试的 6 项任务中,对最偏离正常值的任务进行振动触觉神经反馈训练,每天训练 15 分钟,持续 2 周。

主要观察指标

在训练前、最后一次训练日和 3 个月后,测量真组和假组的躯干和踝关节摆动、头晕障碍清单和前庭症状评分。

结果

真组的躯干和踝关节摆动以及主观症状评分均显著降低。假组的任何结果参数均未发现这种效果。

结论

本研究中应用的振动触觉神经反馈训练是减少不同平衡障碍下身体摆动的一种高效方法。由于康复计划易于执行、不累人且节省时间,因此老年患者和那些患有严重、长期平衡问题的患者也可以成功参与。

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