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Epley法、Semont法及Brandt-Daroff训练对后半规管良性阵发性位置性眩晕(PSCBPPV)患者生活质量的影响

Effect of Epley, Semont Maneuvers and Brandt-Daroff Exercise on Quality of Life in Patients with Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo (PSCBPPV).

作者信息

Gupta Ashok Kumar, Sharma Kumar Gourav, Sharma Pritosh

机构信息

Department of ENT, Geetanjali Medical College and Hospital, Manwa Khera, Udaipur, Rajasthan 313002 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Mar;71(1):99-103. doi: 10.1007/s12070-018-1322-7. Epub 2018 Mar 30.

Abstract

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause in patients with vertigo (Pereira et al. in Braz J Otorhinolaryngol (Impr) 76(6):704-708, 2010; Dix and Hallpike in Ann Otol Rhinol Laryngol 6:987-1016, 1952). Posterior Semicircular Canal BPPV (PSCBPPV) has more incidence and prevalence then Lateral, and Anterior Semicircular Canal BPPV (Alghwiri et al. in Arch Phys Med Rehabil 93:1822-1831, 2012). Quality of life (QoL) is significantly impaired by vertigo (Sargent et al. in Otol Neurotol 22:205-209, 2001; World Health Organization in International classification of functioning, disability and health, World Health Organization, Geneva, 2001). To study the effect and compare Epley, Semont maneuvers and Brandt-Daroff Exercise on QoL in patients with PSCBPPV. 90 individuals with unilateral PSCBPPV were selected based on positive Dix-Hallpike test. 3 groups Epley, Semont, and Brandt-Daroff were formed and 30 individuals were selected in each group randomly. Dix-Hallpike test and Vestibular Activities and Participation (VAP) Scale based on International Classification of Functioning were administered before and after Epley, Semont maneuvers, and Brandt-Daroff Exercise to fulfill the aim. VAP Scale results revealed significant difference between pre and post treatment score in all 3 groups, suggestive of positive effect on QoL in patients with PSCBPPV. Improvements in VAP Score between 3 groups were compared and significant difference was observed. Dix-Hallpike test results revealed that 90, 73.33, and 50% patients improved in Epely, Semont, and Brandt-Daroff group respectively. Epely maneuver found to be the best choice and then Semont and Brandt-Daroff should be least preferred in treatment of patients with PSCBPPV.

摘要

良性阵发性位置性眩晕(BPPV)是眩晕患者最常见的病因(佩雷拉等人,《巴西耳鼻喉科杂志》(印刷版)76(6):704 - 708,2010年;迪克斯和霍尔派克,《耳鼻喉科与鼻咽喉科年鉴》6:987 - 1016,1952年)。后半规管BPPV(PSCBPPV)的发病率和患病率高于水平半规管和前半规管BPPV(阿尔赫维里等人,《物理医学与康复档案》93:1822 - 1831,2012年)。眩晕会显著损害生活质量(萨金特等人,《耳鼻喉科与神经耳科学》22:205 - 209,2001年;世界卫生组织,《功能、残疾与健康国际分类》,世界卫生组织,日内瓦,2001年)。为研究Epley法、Semont法和Brandt - Daroff训练对PSCBPPV患者生活质量的影响并进行比较。基于Dix - Hallpike试验阳性选择90例单侧PSCBPPV患者。将其分为Epley组、Semont组和Brandt - Daroff组,每组随机选取30例患者。在进行Epley法、Semont法和Brandt - Daroff训练前后,进行Dix - Hallpike试验以及基于国际功能分类的前庭活动与参与(VAP)量表评估以实现研究目的。VAP量表结果显示,所有3组治疗前后的评分存在显著差异,提示对PSCBPPV患者的生活质量有积极影响。比较了3组之间VAP评分的改善情况,观察到显著差异。Dix - Hallpike试验结果显示,Epley组、Semont组和Brandt - Daroff组分别有90%、73.33%和50%的患者症状改善。发现Epley法是最佳选择,而Semont法和Brandt - Daroff训练在治疗PSCBPPV患者时应是最不首选的方法。

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