自我管理的前庭康复对持续性姿势-感知性头晕的影响。
The effect of self-management vestibular rehabilitation on persistent postural-perceptual dizziness.
作者信息
Fujimoto Chisato, Oka Mineko, Ichijo Kentaro, Kinoshita Makoto, Kamogashira Teru, Sugasawa Keiko, Kawahara Takuya, Yamasoba Tatsuya
机构信息
Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine The University of Tokyo Bunkyo-ku Tokyo Japan.
Clinical Research Promotion Center The University of Tokyo Hospital Bunkyo-ku Tokyo Japan.
出版信息
Laryngoscope Investig Otolaryngol. 2023 May 29;8(4):1014-1020. doi: 10.1002/lio2.1073. eCollection 2023 Aug.
OBJECTIVE
To investigate the effects of self-management vestibular rehabilitation (VR) on the subjective symptoms of dizziness and postural stability in persistent postural-perceptual dizziness (PPPD).
STUDY DESIGN
Retrospective case review.
METHODS
The medical records of 30 patients newly diagnosed with PPPD based on the Bárány Society's diagnostic criteria were reviewed. Nineteen patients (4 males and 15 females; age range 27-84 years, mean age ± standard deviation 57.4 ± 14.2 years) who was newly instructed to self-management VR were included and instructed to perform self-management VR for 2 months.
RESULTS
One patient did not visit the outpatient clinic again, and in the remaining 18 patients, 4 (22%) discontinued VR at their own discretion. In the 12 patients who completed 2 months of VR (67%), there was a significant improvement in Niigata PPPD Questionnaire (NPQ) and Dizziness Handicap Inventory (DHI) scores after VR compared to those before VR ( < .05). However, the mean velocity of center of pressure (COP) movement (velocity) and the envelopment area traced by COP movement (area), as well as the Romberg ratio and foam ratio of velocity and area, did not differ significantly after VR when compared to those before VR ( > .05).
CONCLUSIONS
For PPPD, self-management VR improved subjective symptoms of dizziness, but not stability of standing posture. It is necessary to improve patients' adherence to the treatment.
LEVEL OF EVIDENCE
目的
探讨自我管理的前庭康复训练（VR）对持续性姿势-感知性头晕（PPPD）患者头晕主观症状及姿势稳定性的影响。
研究设计
回顾性病例分析。
方法
回顾30例根据巴兰尼协会诊断标准新诊断为PPPD患者的病历。纳入19例（4例男性和15例女性；年龄范围27 - 84岁，平均年龄±标准差57.4±14.2岁）新接受自我管理VR训练的患者，并指导其进行2个月的自我管理VR训练。
结果
1例患者未再次到门诊就诊，其余18例患者中，4例（22%）自行停止VR训练。在完成2个月VR训练的12例患者（67%）中，与VR训练前相比，VR训练后新潟PPPD问卷（NPQ）和头晕残障量表（DHI）评分有显著改善（P <.05）。然而，与VR训练前相比，VR训练后压力中心（COP）移动的平均速度（速度）、COP移动轨迹的包络面积（面积）以及速度和面积的罗姆伯格比率和泡沫比率差异均无统计学意义（P >.05）。
结论
对于PPPD患者，自我管理的VR训练可改善头晕主观症状，但不能改善站立姿势稳定性。有必要提高患者对治疗的依从性。
证据水平
4级。
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