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头眼前庭运动疗法对重度慢性脑震荡后患者的身心健康有影响。

Head-Eye Vestibular Motion Therapy Affects the Mental and Physical Health of Severe Chronic Postconcussion Patients.

作者信息

Carrick Frederick Robert, Clark Joseph F, Pagnacco Guido, Antonucci Matthew M, Hankir Ahmed, Zaman Rashid, Oggero Elena

机构信息

Bedfordshire Centre for Mental Health Research in Association with University of Cambridge, Cambridge, United Kingdom.

Neurology, Carrick Institute, Cape Canaveral, FL, United States.

出版信息

Front Neurol. 2017 Aug 22;8:414. doi: 10.3389/fneur.2017.00414. eCollection 2017.

Abstract

CONTEXT

Approximately 1.8-3.6 million annual traumatic brain injuries occur in the United States. An evidence-based treatment for concussions that is reliable and effective has not been available.

OBJECTIVE

The objective of this study is to test whether head-eye vestibular motion (HEVM) therapy is associated with decreased symptoms and increased function in postconcussive syndrome (PCS) patients that have been severely impaired for greater than 6 months after a mild traumatic brain injury.

DESIGN

Retrospective clinical chart review.

SETTING AND PARTICIPANTS

Tertiary Specialist Brain Rehabilitation Center.

INTERVENTIONS

All subjects underwent comprehensive neurological examinations including measurement of eye and head movement. The seven modules of the C3 Logix Comprehensive Concussion Management System were used for pre- and postmeasurements of outcome of HEVM therapy.

MATERIALS AND METHODS

We utilized an objective validated measurement of physical and mental health characteristics of our patients before and after a 1-week HEVM rehabilitation program. We included only PCS patients that were disabled from work or school for a period of time exceeding 6 months after suffering a sports concussion. These subjects all were enrolled in a 5-day HEVM rehabilitation program at our Institutional Brain Center with pre- and post-C3 Logix testing outcomes.

RESULTS

There were statistical and substantive significant decreases in PCS symptom severity after treatment and statistical and substantive significant increases in standardized assessment of concussion scores. The outcomes were associated with positive changes in mental and physical health issues. This is a retrospective review and no control group has been included in this study. These are major limitations with retrospective reviews and further investigations with prospective designs including a randomized controlled study are necessary to further our understanding.

CONCLUSION

Head-eye vestibular motion therapy of 5 days duration is associated with statistical and substantive significant decreases of symptom severity associated with chronic PCS.

摘要

背景

在美国,每年约有180万至360万人发生创伤性脑损伤。目前尚无可靠且有效的基于证据的脑震荡治疗方法。

目的

本研究的目的是测试头眼前庭运动(HEVM)疗法是否与轻度创伤性脑损伤后严重受损超过6个月的脑震荡后综合征(PCS)患者症状减轻和功能增强相关。

设计

回顾性临床病历审查。

地点和参与者

三级专科脑康复中心。

干预措施

所有受试者均接受了包括眼动和头部运动测量在内的全面神经学检查。C3 Logix综合脑震荡管理系统的七个模块用于HEVM疗法结果的前后测量。

材料和方法

我们在为期1周的HEVM康复计划前后,对患者的身心健康特征进行了客观有效的测量。我们仅纳入了因运动性脑震荡而在工作或学校中残疾超过6个月的PCS患者。这些受试者均在我们的机构脑中心参加了为期5天的HEVM康复计划,并进行了C3 Logix前后测试。

结果

治疗后PCS症状严重程度有统计学和实质性显著降低,脑震荡评分的标准化评估有统计学和实质性显著提高。这些结果与身心健康问题的积极变化相关。这是一项回顾性研究,本研究未纳入对照组。回顾性研究存在这些主要局限性,需要进行包括随机对照研究在内的前瞻性设计的进一步调查,以加深我们的理解。

结论

为期5天的头眼前庭运动疗法与慢性PCS相关症状严重程度的统计学和实质性显著降低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a3c/5572417/868cc0a80b60/fneur-08-00414-g001.jpg

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