Herdman S J
Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, Coral Gables 33146-2480, USA.
Phys Ther. 1997 Jun;77(6):602-18. doi: 10.1093/ptj/77.6.602.
This article discusses the pathophysiology, evidence of treatment efficacy, and factors that contribute to improved treatment outcome in three different vestibular disorders. In patients with unilateral and bilateral vestibular loss, recent research suggests that customized, supervised exercises facilitate recovery of postural stability. These exercises are based on knowledge of normal vestibular function as well as on our understanding of the various compensatory mechanisms that can contribute to recovery. Recognizing the limitations of these compensatory mechanisms as substitutes for lost vestibular function is important in establishing treatment goals. Treatment of patients with benign paroxysmal positional vertigo (BPPV) is based on the identification of the specific canal involved and the anatomy of the labyrinth. Although patients with BPPV primarily experience brief episodes of vertigo, this disorder is also associated with postural instability, which may not resolve with remission of the positional vertigo.
本文讨论了三种不同前庭疾病的病理生理学、治疗效果证据以及有助于改善治疗结果的因素。对于单侧和双侧前庭丧失的患者，近期研究表明，定制的、有监督的锻炼有助于姿势稳定性的恢复。这些锻炼基于正常前庭功能的知识以及我们对各种有助于恢复的代偿机制的理解。认识到这些代偿机制作为丧失的前庭功能替代物的局限性，对于确立治疗目标很重要。良性阵发性位置性眩晕（BPPV）患者的治疗基于对受累特定半规管和迷路解剖结构的识别。虽然BPPV患者主要经历短暂的眩晕发作，但这种疾病也与姿势不稳有关，姿势性眩晕缓解后，姿势不稳可能仍无法解决。
