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影响周围性前庭障碍患者前庭康复治疗效果的因素。

Factors affecting the outcome of vestibular rehabilitation in patients with peripheral vestibular disorders.

机构信息

Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, 11-1, Imaihara, Kawanakajima-machi, Nagano-City, Nagano, 381-2227 Japan; Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan.

Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan; Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte-city, Saitama, 340-0145 Japan.

出版信息

Auris Nasus Larynx. 2022 Dec;49(6):950-955. doi: 10.1016/j.anl.2022.03.004. Epub 2022 Mar 17.

Abstract

OBJECTIVE

Previous studies have reported that developmental, environmental, medical, psychological, visual, and other sensory-related factors can influence the outcome of vestibular rehabilitation. However, only a few studies have used patient's daily lives as the main outcome. In addition, in some studies, rehabilitation was not supervised by a physical therapist. This study aimed to determine the factors associated with the outcome of physical-therapist-supervised vestibular rehabilitation in patients with peripheral vestibular disorders, with the impact of dizziness on quality of life as the main outcome.

METHODS

This retrospective cohort study included 47 patients with peripheral vestibular disorders. A physical therapist provided 40 min of vestibular rehabilitation once a week for 4 weeks. Age, sex, disease duration, Dizziness Handicap Inventory (DHI), Timed Up-and-Go test (TUG), Dynamic Gait Index (DGI), Functional Gait Assessment (FGA), Activity-Specific Balance Confidence Scale (ABC scale), and Hospital Anxiety and Depression Scale (HADS) were investigated. Multiple regression analysis was performed, with the DHI rate of change before and after the intervention as the objective variable.

RESULTS

Vestibular rehabilitation improved all outcomes. In the multiple regression analysis, the ABC scale was identified as a factor that significantly influenced the DHI rate of change (β = -0.428, p < 0.01).

CONCLUSION

A higher ABC scale score was associated with a lower DHI rate of change (i.e., better improvement). Therefore, it may be important to assess psychological aspects, especially confidence in balance, when implementing vestibular rehabilitation in patients with peripheral vestibular disorders.

摘要

目的

既往研究报道,发育、环境、医疗、心理、视觉和其他感官相关因素均可能影响前庭康复的结局。但仅有少数研究将患者日常生活作为主要结局。此外,在一些研究中,康复并未由物理治疗师监督。本研究旨在确定与周围性前庭障碍患者经物理治疗师监督的前庭康复结局相关的因素,以头晕对生活质量的影响作为主要结局。

方法

这是一项回顾性队列研究,共纳入 47 例周围性前庭障碍患者。物理治疗师每周提供 40 分钟的前庭康复治疗,持续 4 周。评估的因素包括年龄、性别、疾病持续时间、眩晕残障程度评定量表(DHI)、计时起立-行走测试(TUG)、动态步态指数(DGI)、功能性步态评估(FGA)、活动特异性平衡信心量表(ABC 量表)和医院焦虑抑郁量表(HADS)。采用多元回归分析,以干预前后 DHI 变化率作为因变量。

结果

前庭康复改善了所有结局。在多元回归分析中,ABC 量表被确定为显著影响 DHI 变化率的因素(β=-0.428,p<0.01)。

结论

ABC 量表评分越高,DHI 变化率越低(即改善越好)。因此,在为周围性前庭障碍患者实施前庭康复时,评估心理方面,尤其是平衡信心,可能很重要。

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