Harper Brent A, Steinbeck Larry
Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA.
Department of Physical Therapy, Radford University, Roanoke, VA 24013, USA.
J Funct Morphol Kinesiol. 2024 May 3;9(2):82. doi: 10.3390/jfmk9020082.
Persistent dizziness and balance deficits are common, often with unknown etiology. Persistent Postural-Perceptual Dizziness (3PD) is a relatively new diagnosis with symptoms that may include dizziness, unsteadiness, or non-vertiginous dizziness and be persistent the majority of time over a minimum of 90 days. The purpose of this case series was to investigate short-term outcomes of reducing dizziness symptoms using a manual therapy intervention focused on restoring mobility in the fascia using a pragmatically applied biomechanical approach, the Fascial Manipulation method (FM), in patients with 3PD. The preliminary prospective case series consisted of twelve ( = 12) patients with persistent complaints of dizziness who received systematic application of manual therapy to improve fascial mobility after previously receiving vestibular rehabilitation. The manual therapy consisted of strategic assessment and palpation based on the model proposed in the FM Stecco Method. This model utilizes tangential oscillations directed toward the deep fascia at strategic points. Six males ( = 6) and females ( = 6) were included with a mean age of 68.3 ± 19.3 years. The average number of interventions was 4.5 ± 0.5. Nonparametric paired sample -tests were performed. Significant improvements were observed toward the resolution of symptoms and improved outcomes. The metrics included the Dizziness Handicap Inventory and static and dynamic balance measures. The Dizziness Handicap Inventory scores decreased (i.e., improved) by 43.6 points ( = -3.1 and = 0.002). The timed up and go scores decreased (i.e., improved) by 3.2 s ( = -2.8 and = 0.005). The tandem left increased (i.e., improved) by 8.7 s ( = 2.8 and = 0.005) and the tandem right increased (i.e., improved) by 7.5 s ( = 2.8 and = 0.005). Four to five manual therapy treatment sessions appear to be effective for short-term improvements in dizziness complaints and balance in those with 3PD. These results should be interpreted with caution as future research using rigorous methods and a control group must be conducted.
持续性头晕和平衡功能障碍很常见,病因往往不明。持续性姿势-感知性头晕(PPPD)是一种相对较新的诊断,其症状可能包括头晕、不稳或非眩晕性头晕,且在至少90天的大部分时间里持续存在。本病例系列的目的是研究采用一种手动治疗干预措施,即使用注重通过实用的生物力学方法恢复筋膜活动度的筋膜手法(FM),来减轻PPPD患者头晕症状的短期效果。该初步前瞻性病例系列包括12名持续主诉头晕的患者,他们在先前接受前庭康复治疗后,接受了系统的手动治疗以改善筋膜活动度。手动治疗包括基于FM斯泰科方法中提出的模型进行的策略性评估和触诊。该模型在策略性点处利用朝向深筋膜的切线振动。纳入6名男性和6名女性,平均年龄为68.3±19.3岁。平均干预次数为4.5±0.5次。进行了非参数配对样本检验。观察到症状缓解和结果改善方面有显著改善。指标包括头晕残障量表以及静态和动态平衡测量。头晕残障量表得分降低(即改善)了43.6分(t=-3.1,p=0.002)。计时起立行走测试得分降低(即改善)了3.2秒(t=-2.8,p=0.005)。左向串联站立时间增加(即改善)了8.7秒(t=2.8,p=0.005),右向串联站立时间增加(即改善)了7.5秒(t=2.8,p=0.005)。四到五次手动治疗疗程似乎对短期改善PPPD患者的头晕主诉和平衡功能有效。由于必须使用严格方法并设立对照组进行未来研究,因此这些结果应谨慎解读。