School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
Disabil Rehabil. 2021 Nov;43(23):3291-3297. doi: 10.1080/09638288.2020.1742802. Epub 2020 Mar 26.
Identify the types and dosage of vestibular stimulation interventions in persons with cerebral palsy (CP), and establish the efficacy of these interventions on balance and function.
This systematic review followed Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols to search for studies evaluating vestibular stimulation interventions in persons with CP. Information sources included MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, clinicaltrials.gov and the World Health Organisation registry. Methodological quality was assessed by two independent reviewers using the Methodological Index of Non-Randomised Studies (MINORS) and Cochrane Risk of Bias Tool.
Five articles were included. Three randomised studies were judged to have high risk of bias in at least one domain of the Cochrane Risk of Bias Tool. Two non-randomised studies were rated as low methodological quality using the MINORS tool. All studies used exercise-based vestibular stimulation, but there was little homogeneity regarding dosage. Findings related to efficacy of vestibular stimulation were inconsistent.
Clinical practice recommendations cannot be made due to lack of high quality studies and heterogeneity of treatment protocols. Future research should address theory-driven selection of intervention, establish dosage, use psychometrically robust tools and include all ages of persons with CP.IMPLICATIONS FOR REHABILITATIONOptimal intervention parameters for vestibular stimulation cannot be determined from existing literature.Further studies to describe vestibular stimulation intervention components and duration are warranted.In practice, use of valid and reliable balance and gross motor function outcome measures are essential if using vestibular stimulation techniques with people with CP, as the efficacy of these interventions has not been clearly demonstrated.Investigation of electrical Vestibular Nerve Stimulation in people with CP is warranted.
确定脑瘫患者（CP）前庭刺激干预的类型和剂量，并确定这些干预措施对平衡和功能的疗效。
本系统评价遵循系统评价和荟萃分析方案的首选报告项目，以搜索评估 CP 患者前庭刺激干预的研究。信息来源包括 MEDLINE、Embase、CINAHL、Cochrane 对照试验中心注册库、clinicaltrials.gov 和世界卫生组织注册处。两名独立评审员使用非随机研究方法学指数（MINORS）和 Cochrane 偏倚风险工具评估方法学质量。
纳入了 5 篇文章。3 项随机研究在 Cochrane 偏倚风险工具的至少一个领域被评为高偏倚风险。2 项非随机研究使用 MINORS 工具被评为低方法学质量。所有研究均使用基于运动的前庭刺激，但剂量方面几乎没有一致性。与前庭刺激疗效相关的发现不一致。
由于缺乏高质量研究和治疗方案的异质性，无法提出临床实践建议。未来的研究应针对干预措施的理论驱动选择、确定剂量、使用心理计量学上可靠的工具，并纳入所有年龄的 CP 患者。
无法从现有文献中确定前庭刺激的最佳干预参数。需要进一步研究来描述前庭刺激干预的组成部分和持续时间。在实践中，如果要使用前庭刺激技术治疗 CP 患者，则必须使用有效的和可靠的平衡和粗大运动功能的结果测量，因为这些干预措施的疗效尚未得到明确证明。有必要对 CP 患者的电前庭神经刺激进行研究。
