Krebs D E, Gill-Body K M, Riley P O, Parker S W
Massachusetts General Hospital Institute of Health Professions, Boston 02114.
Otolaryngol Head Neck Surg. 1993 Oct;109(4):735-41. doi: 10.1177/019459989310900417.
Vestibular rehabilitation (VR) is increasingly popular, but few data exist to support enthusiasts' claims of efficacy in improving functional abilities of patients with bilateral vestibular hypofunction (BVH). A double-blind, controlled study of eight subjects (mean, 64 +/- 12 years; seven females, one male) with bilateral vestibular hypofunction was conducted. Subjects in group A received 8 weeks of VR followed by 8 weeks of home VR exercises, whereas those in group B received 8 weeks of control treatment (isometric strengthening exercises) followed by 8 weeks of VR. At the end of 8 weeks, group A walked 8% faster and, during paced gait and stair-climbing, with greater stability, evidenced by a 10% larger maximum moment arm and a 17% decreased double-support duration during gait and stair stance. Group B improved less than 1% during the control treatment. Self-reported Dizziness Handicap Inventory scores did not differ significantly between control and active VR. All subjects improved compared with baseline tests at the 16-week post-test on both functional testing and on the Self-reported Dizziness Handicap Inventory scale. We conclude that in this small sample, VR effectively improved functional, dynamic stability during locomotion, but even strengthening exercises result in self-reported symptomatic improvement.
前庭康复（VR）越来越受欢迎，但几乎没有数据支持其倡导者所宣称的对改善双侧前庭功能减退（BVH）患者功能能力的疗效。对8名双侧前庭功能减退受试者（平均年龄64±12岁；7名女性，1名男性）进行了一项双盲对照研究。A组受试者接受8周的VR治疗，随后进行8周的家庭VR锻炼，而B组受试者先接受8周的对照治疗（等长强化锻炼），然后进行8周的VR治疗。8周结束时，A组步行速度快8%，在有节奏的步态和爬楼梯过程中，稳定性更高，表现为最大力矩臂大10%，步态和楼梯站立时双支撑持续时间减少17%。B组在对照治疗期间改善不到1%。自我报告的头晕残障量表评分在对照治疗和积极的VR治疗之间没有显著差异。在16周后的测试中，所有受试者在功能测试和自我报告的头晕残障量表上与基线测试相比均有改善。我们得出结论，在这个小样本中，VR有效地改善了运动过程中的功能和动态稳定性，但即使是强化锻炼也能带来自我报告的症状改善。
