Chinese General Practice ›› 2022, Vol. 25 ›› Issue (11): 1399-1405.DOI: 10.12114/j.issn.1007-9572.2021.01.104
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Research Advances in Vestibular Rehabilitation Mechanism and Treatment
1.Department of Neurology,Aerospace Center Hospital(Peking University Aerospace School of Clinical Medicine),Beijing 100049,China
2.Department of Neurology,Cangzhou Center Hospital,Cangzhou 061000,China
3.Department Neurology,the First Hospital of Hebei Medical University,Shijiazhuang 050030,China
*Corresponding author:YANG Xu,Chief physician,Associate professor,Master supervisor;E-mail:xuyanghangtian@163.com
Received:
2021-04-11
Revised:
2021-08-06
Published:
2022-04-15
Online:
2022-03-28
通讯作者:
杨旭
基金资助:
CLC Number:
QI Xiaoyuan, SONG Ning, GU Ping, YANG Xu.
Research Advances in Vestibular Rehabilitation Mechanism and Treatment [J]. Chinese General Practice, 2022, 25(11): 1399-1405.
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2021.01.104
类别 | 评价项目 |
---|---|
身体功能变化 | 动态视敏度,凝视稳定性试验,视觉模拟量表,视觉眩晕模拟量表,摇头与感觉整合试验,改良的平衡感觉相互作用临床试验,强化Romberg试验,运动敏感性商,眩晕症状量表 |
身体结构变化 | 脑结构、脊髓和相关结构、内耳结构、心血管结构系统评价 |
活动参与情况 | 动态步态指数,功能性步态评价,步行速度测试,坐位到直立测试,功能性前伸,起立和行走试验,Berg平衡量表,平衡评价系统试验及其简化版,活动特定的平衡信心量表,眩晕评价量表,加州大学洛杉矶分校头晕问卷,眩晕障碍问卷,前庭疾病日常活动量表,前庭活动和参与量表,前庭康复获益问卷 |
环境因素影响 | 供个人消费的产品或物质,个人室内、室外移动和运输的产品及技术,灯光,直系亲属,健康专业人员,健康服务、系统和政策 |
Table 1 International Classification of Functioning,Disability and Health Core Set for patients with vertigo,dizziness and balance disorders
类别 | 评价项目 |
---|---|
身体功能变化 | 动态视敏度,凝视稳定性试验,视觉模拟量表,视觉眩晕模拟量表,摇头与感觉整合试验,改良的平衡感觉相互作用临床试验,强化Romberg试验,运动敏感性商,眩晕症状量表 |
身体结构变化 | 脑结构、脊髓和相关结构、内耳结构、心血管结构系统评价 |
活动参与情况 | 动态步态指数,功能性步态评价,步行速度测试,坐位到直立测试,功能性前伸,起立和行走试验,Berg平衡量表,平衡评价系统试验及其简化版,活动特定的平衡信心量表,眩晕评价量表,加州大学洛杉矶分校头晕问卷,眩晕障碍问卷,前庭疾病日常活动量表,前庭活动和参与量表,前庭康复获益问卷 |
环境因素影响 | 供个人消费的产品或物质,个人室内、室外移动和运输的产品及技术,灯光,直系亲属,健康专业人员,健康服务、系统和政策 |
治疗 | 建议 | 证据级别 |
---|---|---|
扫视训练a | 强烈反对 | Ⅰ |
平滑跟踪训练a | 强烈反对 | Ⅰ |
针对训练 | 中等建议 | Ⅱ |
指导训练 | 中等建议 | Ⅱ |
凝视稳定性训练,每天12~20 minb | 专家意见 | Ⅴ |
Table 2 Current treatment recommendations for persons with peripheral vestibular hypofunction from the APTA
治疗 | 建议 | 证据级别 |
---|---|---|
扫视训练a | 强烈反对 | Ⅰ |
平滑跟踪训练a | 强烈反对 | Ⅰ |
针对训练 | 中等建议 | Ⅱ |
指导训练 | 中等建议 | Ⅱ |
凝视稳定性训练,每天12~20 minb | 专家意见 | Ⅴ |
症状/行为 | 前庭康复 | 认知行为疗法 |
---|---|---|
站姿和步态僵硬(包括共存的功能性步态障碍) | 正常站姿(放松的姿势,正常的体质分布);正常步态(放松的步态,自然的步态,消除不必要的辅助步态) | 减少过度的身体警觉,消除对头晕或摔倒的恐惧 |
运动敏感 | 习服锻炼(逐渐增加头部、眼睛和身体活动) | 减少身体过度警觉,脱敏策略与理疗相辅相成 |
视觉依赖 | 习服训练(逐渐暴露于日益复杂模式和移动的视觉刺激) | 减少身体过度警觉,脱敏策略与理疗相辅相成 |
规避刺激环境 | 逐渐暴露 | 对抗预期性焦虑,促进逐渐暴露 |
Table 3 Recommendations for physical therapy and psychotherapy for persistent postural-perceptual dizziness
症状/行为 | 前庭康复 | 认知行为疗法 |
---|---|---|
站姿和步态僵硬(包括共存的功能性步态障碍) | 正常站姿(放松的姿势,正常的体质分布);正常步态(放松的步态,自然的步态,消除不必要的辅助步态) | 减少过度的身体警觉,消除对头晕或摔倒的恐惧 |
运动敏感 | 习服锻炼(逐渐增加头部、眼睛和身体活动) | 减少身体过度警觉,脱敏策略与理疗相辅相成 |
视觉依赖 | 习服训练(逐渐暴露于日益复杂模式和移动的视觉刺激) | 减少身体过度警觉,脱敏策略与理疗相辅相成 |
规避刺激环境 | 逐渐暴露 | 对抗预期性焦虑,促进逐渐暴露 |
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