Ekvall Hansson Eva, Pessah-Rasmussen Hélène, Bring Annika, Vahlberg Birgit, Persson Liselott
Department of Health Sciences, Division of Physiotherapy, Lund University, Health Science Centre, Box 157, 221 00 Lund, Sweden.
Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
Pilot Feasibility Stud. 2020 Sep 30;6:146. doi: 10.1186/s40814-020-00690-2. eCollection 2020.
Dizziness is common among patients with first time stroke. It affects self-perceived health and is a risk factor for falls. Vestibular rehabilitation (VR) is effective for treating dizziness among various conditions, but the effect of dizziness with origin in the central nervous system is poorly studied.This pilot study of a randomized controlled trial aimed at investigating a vestibular rehabilitation programme among patients with first time stroke and concomitant dizziness. A second aim was to study the feasibility of performing the randomized controlled trial.
The participants were computer generated randomized to either an intervention or a control group. The intervention comprised of four different vestibular rehabilitation exercises, adapted for each patient and usual rehabilitation. The control group received usual rehabilitation without the vestibular rehabilitation exercises. Outcome measures used were The Activities-specific Balance Confidence Scale, the Berg Balance Scale, the Functional Gait Assessment Scale and the EuroQol-5D. Feasibility was studied in terms of recruitment, adherence and retention rates, also as the ability to collect primary and secondary outcomes as well as to find indications of treatment differences.
Self-rated health improved for all participants. No other differences between baseline and follow-up were detected neither within nor between groups. Recruitment rate was 23%, adherence to the intervention 90%, retention rate 69% and ability to collect outcome measures 90%. No adverse events occurred.
Both the intervention and the control groups improved in self-perceived health. The measures of feasibility were satisfactory in this study, apart from a low recruitment rate.
头晕在首次中风患者中很常见。它会影响自我感知的健康状况,并且是跌倒的一个风险因素。前庭康复(VR)在治疗各种情况下的头晕方面是有效的,但对于起源于中枢神经系统的头晕的影响研究较少。这项随机对照试验的初步研究旨在调查首次中风并伴有头晕的患者的前庭康复计划。第二个目的是研究进行随机对照试验的可行性。
参与者通过计算机随机分为干预组或对照组。干预包括四种不同的前庭康复练习,针对每个患者进行调整并结合常规康复。对照组接受不包括前庭康复练习的常规康复。使用的结局指标有特定活动平衡信心量表、伯格平衡量表、功能性步态评估量表和欧洲五维健康量表。从招募、依从性和保留率方面研究可行性,同时也包括收集主要和次要结局指标以及发现治疗差异迹象的能力。
所有参与者的自我健康评分均有所改善。在组内和组间,基线和随访之间均未检测到其他差异。招募率为23%,干预依从性为90%,保留率为69%,收集结局指标的能力为90%。未发生不良事件。
干预组和对照组的自我感知健康状况均有所改善。除了招募率较低外,本研究中的可行性指标令人满意。