Thompson Karla J, Goetting Jay C, Staab Jeffrey P, Shepard Neil T
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
J Vestib Res. 2015;25(2):97-103; quiz 103-4. doi: 10.3233/VES-150551.
Persistent postural-perceptual dizziness (PPPD) (formerly chronic subjective dizziness) may be treated using the habituation form of vestibular and balance rehabilitation therapy (VBRT), but therapeutic outcomes have not been formally investigated.
This pilot study gathered the first data on the efficacy of VBRT for individuals with well-characterized PPPD alone or PPPD plus neurotologic comorbidities (vestibular migraine or compensated vestibular deficits).
Twenty-six participants were surveyed by telephone an average of 27.5 months after receiving education about PPPD and instructions for home-based VBRT programs. Participants were queried about exercise compliance, perceived benefits of therapy, degree of visual or motion sensitivity remaining, disability level, and other interventions.
Twenty-two of 26 participants found physical therapy consultation helpful. Fourteen found VBRT exercises beneficial, including 8 of 12 who had PPPD alone and 6 of 14 who had PPPD with co-morbidities. Of the 14 participants who found VBRT helpful, 7 obtained relief of sensitivity to head/body motion, 5 relief of sensitivity to visual stimuli, and 4 complete remission. Comparable numbers for the 12 participants who found VBRT not helpful were 1 (head/body motion), 3 (visual stimuli), and 0 (remission).
This pilot study offers the first data supporting the habituation form of VBRT for treatment of PPPD.
持续性姿势-感知性头晕(PPPD)(原称慢性主观性头晕)可采用前庭与平衡康复治疗(VBRT)的习惯化形式进行治疗,但治疗效果尚未得到正式研究。
这项初步研究收集了关于VBRT对单纯确诊为PPPD或伴有神经耳科合并症(前庭性偏头痛或代偿性前庭功能缺损)的个体疗效的首批数据。
26名参与者在接受关于PPPD的教育及家庭VBRT计划指导后,平均27.5个月通过电话接受调查。询问参与者关于运动依从性、治疗的感知益处、剩余的视觉或运动敏感程度、残疾水平及其他干预措施。
26名参与者中有22人认为物理治疗咨询有帮助。14人认为VBRT练习有益,其中12名单纯患有PPPD的参与者中有8人,14名患有合并症的PPPD参与者中有6人。在认为VBRT有帮助的14名参与者中,7人对头/身体运动的敏感性得到缓解,5人对视觉刺激的敏感性得到缓解,4人完全缓解。在认为VBRT无帮助的12名参与者中,相应数字分别为1人(头/身体运动)、3人(视觉刺激)和0人(缓解)。
这项初步研究提供了支持VBRT习惯化形式治疗PPPD的首批数据。