van Vugt Vincent A, de Kruif Anja JThCM, van der Wouden Johannes C, van der Horst Henriëtte E, Maarsingh Otto R
Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
BJGP Open. 2020 Dec 15;4(5). doi: 10.3399/bjgpopen20X101092. Print 2020 Dec.
Internet-based vestibular rehabilitation (VR) with physiotherapy support, known as blended VR, was effective in reducing vestibular symptoms in a recent randomised controlled trial. Blended VR is a complex intervention comprised of physiotherapeutic visits, the vertigo training website, and VR exercises. Because of these interacting components, it is important to understand how blended VR works, for whom it works best, and how it should ideally be delivered.
To investigate the experiences of both patients and physiotherapists with blended internet-based VR.
DESIGN & SETTING: A qualitative interview study was performed with patients who received blended internet-based VR with physiotherapy support, and physiotherapists who provided this support.
Semi-structured interviews were conducted with 14 patients and eight physiotherapists after the 6-month follow-up of the randomised trial. All interviews were audio-recorded, transcribed, and thematically analysed.
According to both patients and physiotherapists, the physiotherapist visits were useful in providing personal attention, helping patients safely execute exercises, and improving patients' adherence to therapy. Some patients said they did not need physiotherapist support and, according to physiotherapists, both the necessity and the optimal way to deliver guidance differed greatly between patients. The Vertigo Training website and exercises provided patients with a sense of control over their symptoms. Patients reported that the VR exercises were easy to perform and most patients continued to use them long after the trial ended.
In blended VR, physiotherapeutic visits appear to offer benefits above the vertigo training website and VR exercises alone. Physiotherapy support may best be used when individually tailored.
在最近一项随机对照试验中，基于互联网的前庭康复（VR）结合物理治疗支持，即混合式VR，在减轻前庭症状方面是有效的。混合式VR是一种复杂的干预措施，包括物理治疗门诊、眩晕训练网站和VR练习。由于这些组成部分相互作用，了解混合式VR的工作原理、对谁最有效以及理想的实施方式非常重要。
调查患者和物理治疗师对基于互联网的混合式VR的体验。
对接受基于互联网的混合式VR并获得物理治疗支持的患者以及提供这种支持的物理治疗师进行了定性访谈研究。
在随机试验的6个月随访后，对14名患者和8名物理治疗师进行了半结构化访谈。所有访谈均进行了录音、转录并进行了主题分析。
患者和物理治疗师都认为，物理治疗门诊有助于提供个性化关注、帮助患者安全地进行练习并提高患者对治疗的依从性。一些患者表示他们不需要物理治疗师的支持，而且根据物理治疗师的说法，患者之间提供指导的必要性和最佳方式差异很大。眩晕训练网站和练习让患者对自己的症状有了控制感。患者报告说VR练习很容易进行，而且大多数患者在试验结束后很长时间仍继续使用。
在混合式VR中，物理治疗门诊似乎比单独的眩晕训练网站和VR练习更有益。物理治疗支持最好根据个体情况量身定制。
