个体化前庭康复训练应用于慢性周围性前庭功能障碍的疗效评估

Efficacy of individualized vestibular rehabilitation training in patients with chronic peripheral vestibular dysfunction

目的:探讨并评价通过头-眼运动训练视频进行个体化前庭康复训练在慢性周围性前庭功能障碍患者中的疗效。方法:选取慢性周围性前庭功能障碍的患者60例,随机纳入观察组和对照组各30例,观察组通过头-眼运动训练视频进行个体化前庭康复训练,对照组行传统Cawthorne-Cooksey法前庭康复训练,分别于训练前、训练后2周、4周、12周对患者进行评估。结果:观察组头晕残障量表-躯体部分(DHI-P)评分训练2周后较训练前降低(P<0.05),训练4周、12周后,DHI各项评分均较训练前明显降低(均P<0.01),特异性活动平衡自信量表(ABC)评分较训练前均明显提高(均P<0.01)。对照组DHI各项评分训练4周与训练前比较均明显降低(均P<0.05),训练12周DHI各项评分均较训练前明显降低(均P<0.01),ABC评分较训练前明显提高(P<0.01)。2组组间同期比较,训练4周后,观察组DHI各项评分较对照组均明显降低(P<0.05,0.01),ABC评分明显提高(P<0.05);2组患者在训练开始后12周闭目直立试验阳性率均明显降低(P<0.05),踏步试验及前庭双温试验阳性率2组比较差异无统计学意义。结论:对于慢性周围性前庭功能障碍的患者前庭康复训练能够获得满意的疗效,通过头-眼运动训练视频进行个体化前庭康复训练较传统的Cawthorne-Cooksey训练法起效更快,值得临床推广。

Objective:To explore and evaluate the efficacy of individualized vestibular rehabilitation training by head-eye exercise video in patients with chronic peripheral vestibular dysfunction.Methods:A total of 60 patients with chronic peripheral vestibular dysfunction were randomly divided into the observation group and the control group,n=30 each.The observation group received individualized vestibular rehabilitation training through the video of head-eye exercise.The control group was given traditional Cawthorne-Cooksey vestibular rehabilitation training.The patients were evaluated before,2,4 and 12 weeks after the training.Results:In the observation group,DHI-P scores after 2 weeks of training were significantly lower than those before training(P<0.05),after 4 weeks and 12 weeks of training,DHI scores were significantly lower than those before training(all P<0.01);and ABC scores were significantly higher than those before training(all P<0.01).DHI-P,DHI-E and DHI-T scores in the control group were significantly decreased at 4th week of training as compared with those before training(all P<0.05),DHI scores at 12th week of training were significantly decreased as compared with those before training(all P<0.01),and ABC scores were significantly increased as compared with those before training(all P<0.01).For comparison at the same period between the two groups,after 4 weeks of training,DHI scores in the observation group were significantly lower than those in the control group(P<0.05,0.01),and ABC scores were significantly increased(P<0.05);after 12 weeks of training,the positive rate of Romberg test was significantly decreased(P<0.05),but the positive rate of Fukuda step test and bithermal caloric test between two groups had no significant difference.Conclusion:For patients with chronic peripheral vestibular dysfunction,vestibular rehabilitation training can achieve satisfactory results.Individualized vestibular rehabilitation training through head-eye exercise video can obtain the efficacy faster than the traditional Cawthorne-Cooksey training method,which is worthy of clinical promotion.