Yıldız Güvercin Ezgi, Kirazlı Yeşim, Üzümcügil Hale, Çınar Ece, Baklacı Musa, Kirazlı Gülce, Kirazlı Tayfun, Çelebisoy Neşe, Gökçay Figen
Department of Physical Therapy and Rehabilitation, Doç. Dr. Mustafa Kalemli Tavşanlı State Hospital, Kütahya, Türkiye.
Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, İzmir, Türkiye.
Turk J Phys Med Rehabil. 2024 Sep 17;71(2):187-198. doi: 10.5606/tftrd.2024.14692. eCollection 2025 Jun.
The aim of this study was to investigate the effect of neck exercises in addition to vestibular rehabilitation treatment in unilateral peripheral vestibular system (PVS) diseases accompanied by neck pain and to evaluate the relationship between neck pain severity and clinical balance parameters in this patient population.
In this prospective, randomized-controlled study, a total of 70 patients (30 males, 40 females; mean age: 52.6±14.9 years; range, 37 to 68 years) who were diagnosed with unilateral PVS disease with concomitant neck pain were included between September 2019 and May 2022. The patients were randomized into two equal groups. Group 1 (n=35) received a vestibular rehabilitation program for four weeks, and Group 2 (n=35) received neck exercises in addition to the standard rehabilitation protocol. As the compensation improved in the vestibular rehabilitation treatment, additional compelling exercises were added to the program. At Week 4, all patients were evaluated with clinical parameters including the severity of balance, neck pain, dizziness, Dizziness Handicap Inventory (DHI), Functional Gait Assessment (FGA), Activity-specific Balance Confidence (ABC) scale, Dynamic Gait Index (DGI), Berg Balance Scale (BBS), Timed Up-and-Go (TUG) test, Falls Efficacy Scale (FES)-International, postural stability, and Neck Disability Index (NDI).
After the rehabilitation program, a statistically significant improvement was observed in all clinical parameters in both groups (p<0.05). Compared to Group 1, there was a statistically significant difference in all other clinical parameters in Group 2, except for the two parameters: the Romberg eye-open time and TUG test (p<0.05). A significant correlation was found between the severity of neck pain and the severity of dizziness, BBS, DHI, FGA, and NDI (p<0.05).
Neck exercises may yield positive clinical outcomes when combined with vestibular rehabilitation and should be taken into consideration for planning rehabilitation program in patients with unilateral PVS disease and neck pain.
本研究旨在探讨颈部锻炼联合前庭康复治疗对伴有颈部疼痛的单侧外周前庭系统（PVS）疾病的影响，并评估该患者群体中颈部疼痛严重程度与临床平衡参数之间的关系。
在这项前瞻性随机对照研究中，纳入了2019年9月至2022年5月期间诊断为单侧PVS疾病并伴有颈部疼痛的70例患者（30例男性，40例女性；平均年龄：52.6±14.9岁；范围37至68岁）。患者被随机分为两组。第1组（n = 35）接受为期四周的前庭康复计划，第2组（n = 35）除标准康复方案外还接受颈部锻炼。随着前庭康复治疗中代偿功能的改善，计划中增加了额外的强化锻炼。在第4周时，对所有患者进行临床参数评估，包括平衡、颈部疼痛、头晕的严重程度、头晕残障量表（DHI）、功能性步态评估（FGA）、特定活动平衡信心（ABC）量表、动态步态指数（DGI）、伯格平衡量表（BBS）、定时起立行走（TUG）测试、国际跌倒效能量表（FES）、姿势稳定性和颈部残疾指数（NDI）。
康复计划后，两组所有临床参数均有统计学意义的改善（p < 0.05）。与第1组相比，第2组除两个参数（睁眼罗姆伯格时间和TUG测试）外的所有其他临床参数均有统计学意义的差异（p < 0.05）。发现颈部疼痛严重程度与头晕严重程度、BBS、DHI、FGA和NDI之间存在显著相关性（p < 0.05）。
颈部锻炼与前庭康复联合应用时可能产生积极的临床效果，在为单侧PVS疾病和颈部疼痛患者制定康复计划时应予以考虑。
