前庭康复治疗对平衡障碍患者的疗效分析

A Clinical Analysis of Vestibular Rehabilitation Therapy for Patients with Balance Disorders

王密;卢伟;

1:郑州大学第一附属医院耳科

摘要
目的探讨前庭康复治疗(vestibular rehabilitation therapy,VRT)对平衡障碍患者的疗效。方法对76例平衡障碍患者根据单、双侧及针对性康复原则随机分为四组,A组(单侧)29例为单纯药物组,B组(单侧)29例为药物联合前庭康复组;C组(双侧)9例为单纯药物组,D组(双侧)9例为药物联合前庭康复组,分别给予药物联合前庭康复训练治疗或单纯药物治疗,疗程4周,采用前庭症状指数(vestibular symptom index,VSI)主观评估,Berg平衡量表(Berg balance scale,BBS)、功能性伸手试验及Fukuda踏步试验评估平衡功能,比较各组的疗效。结果 4组患者治疗后VSI评分均明显低于治疗前(P<0.01);无论单侧或双侧平衡障碍患者,药物联合前庭康复治疗组患者治疗后BBS评分、功能性伸手试验、Fukuda踏步等平衡功能均明显优于单纯药物治疗组(均为P<0.01)。结论前庭康复训练联合药物治疗平衡障碍患者的效果优于单纯药物治疗,前庭康复训练可作为前庭功能减退平衡功能障碍患者的辅助疗法。
关键词
前庭康复治疗;前庭功能减退;平衡障碍
基金项目(Foundation):
作者
王密;卢伟;
参考文献

1 鄢波,孔维佳,师洪,等.高压氧辅助治疗突发性聋的疗效评价[J].临床耳鼻咽喉科杂志,2006,20:309.

2 王尔贵,吴子明.前庭康复-前庭系统疾病诊断与治疗[M].第2版.北京:人民军医出版社,2004.281~283.

3 Black FO,Angel CR,Pesznecker SC,et al.Outcome analysis of individualized vestibular reha bilitation protocols[J].American Journal of Otolaryngology,2000,21:543.

4 Cass SP,Borello-France D,Furman JM.Functional outcome of vestibular rehabilitation in patients with abnormal sensoryorganization testing[J].Am J Otol,1996,17:581.

5 Carmona S,Ferrero A,Pianetti G,et al.Galvanic vestibular stimulation improves the results of vestibular rehabilitation[J].Annals of the New York Academy of Sciences,2011,1233:E1.

6 Dowdal-Osborn M.Early vestibular rehabilitation in patients with Meniere's disease[J].Otolaryngologic Clinics of North America,2002,35:683.

7 Shinichiro H,Koji T,Hideaki N,et al.Effect of Rehabilitation in Patients with Vertigo[J].Equilibrium Research,2009,58:623.

8 Horak FB.Postural compensation for vestibular loss and implications for rehabilitation[J].Restor Neurol Neurosci,2010,28:57.

9 Cohen HS,Kimball KT.Usefulness of some current balance tests for identifying individuals with disequilibrium due to vestibular impairments[J].Journal of Vestibular Research:Equilibrium&Orientation,2008,18:295.

10 孔维佳,刘波,吴青,等.不同厚度海绵垫对健康人直立姿势稳定性的影响[J].中华耳鼻咽喉头颈外科杂志,2007,42:721.

11 El-Kahky AM,Kingma H,Dolmans M.Balance control near the limit of stability in various sensory conditions in healthy subjects and patients suffering from vertigo and balance disorders:impact of sensory input on balance control[J].Acta Oto-Laryngologica,2000,120:508.

12 Wrisley DM,Whitney SL.The effect of foot position on the modified clinical test of sensory interaction and balance[J].Archives of Physical Medicine and Rehabilitation,2004:335.

13 Amin M,Girardi M,Konrad HR.A comparison of electronystagmography results with posturography finding from the BalanceTrak 500[J].Otology and Neurotology,2002,23:488.

14 刘波,孔维佳,赖嫦芹,等.站立于海绵垫及坚硬平板时头部后仰对正常人姿势稳定性的影响[J].中华耳科学杂志,2006,4:262.

15 Chiang JH,Wu G.The influence of foam surfaces on the biomechanical variables contributing to postural control[J].Gait&Posture,1997,5:239.

16 迟放鲁,郭丽敏,张庆陵.人体倾角姿势图仪和球底平衡台的临床应用[J].中华医学杂志,2003,23:2064.

17 Hillier SL,McDonnell M.Vestibular rehailitation for unilateral peripheral vestibular dysfunction[J].Clin Otolaryngol,2011,36:248.

18 Yardley L,Beech S,Zander L,et al.A randomized controlled trial of exercise therapy for dizziness and vertigo in primary care[J].Br J Gen Pract,1998,48:1136.

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