Mruzek M, Barin K, Nichols D S, Burnett C N, Welling D B
Department of Otolaryngology, Ohio State University, Columbus, USA.
Laryngoscope. 1995 Jul;105(7 Pt 1):686-92. doi: 10.1288/00005537-199507000-00004.
This study investigated the relative effects of vestibular rehabilitation (VR) and social reinforcement (SR) on recovery following ablative vestibular surgery. Twenty-four subjects were randomly assigned to three treatment groups of either VR with SR, VR without SR, or general range of motion (ROM) exercises with SR. Outcome measures included equilibrium scores in dynamic posturography, asymmetry index in rotation testing, motion sensitivity quotient (MSQ), and dizziness handicap inventory (DHI). A multiple comparison of the overall outcome measures showed no significant differences in group performance over an 8-week period. When individual outcome measures were compared, MSQ and DHI results at the end of the 8-week treatment period revealed less motion sensitivity and dizziness handicap in groups who received VR, with or without SR, as compared with the group who received ROM exercises. These results suggest that after a vestibular injury most patients can effectively utilize central compensation mechanisms to recover from such an injury, regardless of the type of therapeutic intervention used. On the other hand, the reduction in motion sensitivity and dizziness handicap for patients who received VR could indicate a more rapid and complete recovery for these patients. This investigation is continuing as a long-term follow-up study to determine whether there are any long-term benefits in participating in a VR program.
本研究调查了前庭康复(VR)和社会强化(SR)对前庭切除术后恢复的相对影响。24名受试者被随机分配到三个治疗组,分别接受伴有SR的VR、不伴有SR的VR或伴有SR的一般活动范围(ROM)锻炼。结果指标包括动态姿势描记法中的平衡分数、旋转测试中的不对称指数、运动敏感商(MSQ)和头晕残障量表(DHI)。对总体结果指标的多重比较显示,在8周的时间里,各治疗组的表现没有显著差异。当对个体结果指标进行比较时,8周治疗期结束时的MSQ和DHI结果显示,与接受ROM锻炼的组相比,接受VR(无论是否伴有SR)的组运动敏感性和头晕残障程度更低。这些结果表明,在前庭损伤后,大多数患者可以有效地利用中枢补偿机制从这种损伤中恢复,无论采用何种治疗干预方式。另一方面,接受VR治疗的患者运动敏感性和头晕残障程度的降低可能表明这些患者恢复得更快、更彻底。本调查正在作为一项长期随访研究继续进行,以确定参与VR项目是否有任何长期益处。