Jaroshevskyi Olexandr A, Payenok Oleksandr S, Logvinenko Anna V
Department of Reflexology Medical Academy of Postgraduate Education, Kharkіv, Ukraine.
Department of Physical Rehabilitation State University of Physical Culture, Lviv, Ukraine.
Wiad Lek. 2017;70(3 pt 2):571-573.
Vertigo is one of the most common complaints among patients consulting neurologists and general practitioners - family medicine. A special form of dizziness is cervical vertigo. However, the presence of chronic vertigo and imbalance in this group of patients makes it possible to include the treatment of vestibular rehabilitation in the program.
Evalution of the effectiveness of multimodal approach to the management of cervical vertigo.
109 patients aged from 18 to 45 with vertigo together with myofascial pain syndrome of neck and shoulder area were examined. The survey included a sample of Dix-Hallpike, neurological and otoneurological examinations, Doppler ultrasound of the main arteries of the head and neck, brain MRI, functional spondylography of the cervical spine. For quantitive evaluation of the impact of vertigo on daily life the questionnaire DHI (Dizziness Handicap Inventory) was used. Testing was performed in two stages - before treatment and in 2 weeks' time. Patients were randomly divided into 3 groups which differ in their therapeutic tactics.
In all three groups the normalization of the biomechanical pattern and elimination of musculo-tonic disorders accompanied by a decrease of a pain syndrome and a decrease in the severity or complete regression of dizziness and postural instability. At the same time, in groups 2 and 3, in which in addition to manual therapy, patients received acupuncture, there was a distinct positive dynamics of a pain syndrome according to VAS, Neck Disability Index and the Dizziness Handicap Inventory. A marked regression of vertigo and postural instability can be observed in patients in which the treatment along with manual therapy and acupuncture, a complex of vestibular rehabilitation was used.
The multimodal approach using manual therapy in combination with acupuncture and vestibular rehabilitation showed the maximum therapeutic effect on elimination of musculo-tonic disorders, reduction of a pain syndrome with a complete regression of vertigo and postural instability.
眩晕是咨询神经科医生和全科医生（家庭医学）的患者中最常见的主诉之一。一种特殊形式的头晕是颈性眩晕。然而，这组患者中慢性眩晕和平衡失调的存在使得在前庭康复治疗方案中纳入该治疗成为可能。
评估多模式方法治疗颈性眩晕的有效性。
对109例年龄在18至45岁之间、患有眩晕以及颈肩区域肌筋膜疼痛综合征的患者进行了检查。检查包括Dix-Hallpike试验、神经和耳神经学检查、头颈部主要动脉的多普勒超声检查、脑部MRI、颈椎功能脊椎造影。为了定量评估眩晕对日常生活的影响，使用了DHI（头晕残障量表）问卷。测试分两个阶段进行——治疗前和治疗两周后。患者被随机分为3组，每组治疗策略不同。
在所有三组中，生物力学模式均恢复正常，肌肉紧张性障碍得以消除，同时疼痛综合征减轻，头晕和姿势不稳的严重程度降低或完全消退。与此同时，在第2组和第3组中，除手法治疗外，患者还接受了针灸治疗，根据视觉模拟评分法（VAS）、颈部残疾指数和头晕残障量表，疼痛综合征呈现出明显的积极变化。在采用手法治疗、针灸以及前庭康复综合治疗的患者中，可以观察到眩晕和姿势不稳明显消退。
采用手法治疗、针灸和前庭康复相结合的多模式方法，在消除肌肉紧张性障碍、减轻疼痛综合征以及使眩晕和姿势不稳完全消退方面显示出最大的治疗效果。
