Strupp M, Arbusow V, Maag K P, Gall C, Brandt T
Department of Neurology, Ludwig-Maximilians-University Munich, Klinikum Grosshadern, Germany.
Neurology. 1998 Sep;51(3):838-44. doi: 10.1212/wnl.51.3.838.
Animal experiments have shown that central vestibular compensation of unilateral peripheral vestibular lesions can be improved by vestibular exercises. There are, however, no equivalent clinical studies on the efficacy of such specific physiotherapy on acute unilateral peripheral vestibular lesions in humans.
To quantify the differential effects of specific vestibular exercises on central compensation in patients with an acute/subacute unilateral vestibular lesion (vestibular neuritis), we determined the time course of recovery of 1) the ocular torsion (OT) for the vestibulo-ocular system, 2) the subjective visual vertical (SVV) for perception, and 3) the total sway path (SP) values for postural control in 19 patients with and 20 patients without vestibular exercises. All patients had a persisting peripheral vestibular deficit for at least 30 days (statistical end point).
Although normalization of OT and SVV was similar in the control and physiotherapy groups, the total SP values on day 30 after symptom onset differed significantly: 3.2 +/- 1.9 m/min in the physiotherapy group and 16.9 +/- 6.1 m/min in the control group (ANOVA, p < 0.001).
This prospective clinical study suggests that specific vestibular exercises improve vestibulospinal compensation in patients with acute peripheral vestibular lesions.
动物实验表明，前庭锻炼可改善单侧外周前庭病变的中枢前庭代偿。然而，尚无关于此类特定物理疗法对人类急性单侧外周前庭病变疗效的等效临床研究。
为量化特定前庭锻炼对急性/亚急性单侧前庭病变（前庭神经炎）患者中枢代偿的不同影响，我们确定了19例接受前庭锻炼和20例未接受前庭锻炼患者的以下指标恢复的时间进程：1）前庭眼反射系统的眼扭转（OT）；2）用于感知的主观视觉垂直（SVV）；3）姿势控制的总摆动路径（SP）值。所有患者外周前庭功能持续缺损至少30天（统计终点）。
尽管对照组和物理治疗组的OT和SVV恢复正常情况相似，但症状出现后第30天的总SP值差异显著：物理治疗组为3.2±1.9米/分钟，对照组为16.9±6.1米/分钟（方差分析，p<0.001）。
这项前瞻性临床研究表明，特定的前庭锻炼可改善急性外周前庭病变患者的前庭脊髓代偿。
