Shiozaki Tomoyuki, Ito Taeko, Wada Yoshiro, Yamanaka Toshiaki, Kitahara Tadashi
Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan.
Front Neurol. 2021 Apr 29;12:656157. doi: 10.3389/fneur.2021.656157. eCollection 2021.
The present study aimed to determine whether supervised vestibular rehabilitation therapy (VRT) by physical therapists (PTs) affects subjective dizziness in patients with chronic vestibular disorders, and whether supervised VRT-induced changes in subjective dizziness are related to the changes in physical activity levels in daily life. Patients ( = 47) with chronic peripheral vestibular disorders were randomly divided into the VRT group ( = 25) and control group ( = 22). Patients in the VRT group received weekly supervised visits from PTs for a period of 6 months. Every other month, both groups were advised by neuro-otologists to increase the amount of activity in their daily life. All patients wore an accelerometer device, which recorded their physical activity for seven successive days before the end of the intervention. Patients also completed the dizziness and unsteadiness questionnaires before and after the intervention. Subjective dizziness decreased significantly regardless of whether supervised VRT was administered; however, dizziness evoked by social activity and head and body movements improved more significantly in the VRT group than in the control group. In the VRT group, there was a significant negative correlation between the increase in sedentary behavior and improvement in subjective dizziness, and a significant positive correlation between the increase in light physical activity and improvement in subjective dizziness at the second month of intervention. The VRT group showed a significantly higher rate of increase in light physical activity than the control group, after 6 months of intervention. Supervised VRT could be highly effective in treating subjective dizziness in patients with chronic peripheral vestibular disorders. We believe frequent (weekly) and medium-term (6 months) PT-guided interventions may be highly effective in enhancing physical activity in daily life, and may subsequently improve subjective dizziness in these patients. This clinical study was registered with University hospital Medical Information Network (identification number: 000028832). https://www.umin.ac.jp/.
本研究旨在确定物理治疗师(PT)进行的监督性前庭康复治疗(VRT)是否会影响慢性前庭疾病患者的主观头晕,以及监督性VRT引起的主观头晕变化是否与日常生活中身体活动水平的变化相关。47例慢性外周性前庭疾病患者被随机分为VRT组(25例)和对照组(22例)。VRT组患者每周接受PT的监督性问诊,为期6个月。每隔一个月,神经耳科医生会建议两组患者增加日常生活中的活动量。所有患者均佩戴加速度计设备,该设备在干预结束前连续七天记录他们的身体活动情况。患者还在干预前后完成了头晕和不稳问卷。无论是否进行监督性VRT,主观头晕均显著降低;然而,VRT组中社交活动以及头部和身体运动引起的头晕改善比对照组更显著。在VRT组中,干预第二个月时,久坐行为增加与主观头晕改善之间存在显著负相关,轻度身体活动增加与主观头晕改善之间存在显著正相关。干预6个月后,VRT组的轻度身体活动增加率显著高于对照组。监督性VRT在治疗慢性外周性前庭疾病患者的主观头晕方面可能非常有效。我们认为频繁(每周)和中期(6个月)的PT指导干预可能在增强日常生活中的身体活动方面非常有效,并可能随后改善这些患者的主观头晕。本临床研究已在大学医院医学信息网络注册(识别号:000028832)。https://www.umin.ac.jp/