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前庭康復(fù)網(wǎng)絡(luò)干預(yù)對老年慢性頭暈患者的效果:一項英國社區(qū)醫(yī)療機(jī)構(gòu)開展的隨機(jī)對照試驗

發(fā)布時間:2018-03-10 01:10

  本文選題:前庭 切入點:社區(qū)醫(yī)療機(jī)構(gòu) 出處:《中國全科醫(yī)學(xué)》2017年28期  論文類型:期刊論文


【摘要】:目的前庭康復(fù)治療對由前庭功能障礙所致的眩暈來說比較有效,但迄今為止這種康復(fù)治療的開展還較少。本研究旨在探討前庭康復(fù)網(wǎng)絡(luò)干預(yù)項目在社區(qū)老年慢性頭暈患者中的效果。方法本項為單中心、單盲的隨機(jī)對照試驗,在英格蘭南部54家社區(qū)醫(yī)療機(jī)構(gòu)開展。研究對象為來自這些機(jī)構(gòu)的年齡≥50歲、患有眩暈并頭部運(yùn)動眩暈加重的患者;颊弑浑S機(jī)分為干預(yù)組和普通治療組。干預(yù)組給予前庭康復(fù)網(wǎng)絡(luò)干預(yù)[平衡訓(xùn)練(患者通過網(wǎng)絡(luò)學(xué)習(xí)前庭康復(fù)訓(xùn)練及認(rèn)知行為管理策略),詳細(xì)內(nèi)容見https://balance.lifeguidehealth.org],普通治療組給予普通全科治療。在干預(yù)前、干預(yù)3個月及6個月后,采用簡明眩暈癥狀量表(VSS-SF)對患者的眩暈程度進(jìn)行調(diào)查。干預(yù)效果的主要評估指標(biāo)為干預(yù)6個月后的VSS-SF分?jǐn)?shù)。結(jié)果共納入296例患者,其中66%為女性,中位年齡為67歲。250例(84%)患者在干預(yù)3個月后完成了VSS-SF測評,230例(78%)患者在干預(yù)6個月后完成了VSS-SF測評。干預(yù)3個月后,干預(yù)組VSS-SF分?jǐn)?shù)比普通治療組低2.75分[95%CI(1.39,4.12),P0.001];干預(yù)組眩暈殘障程度分?jǐn)?shù)比普通治療組低6.15分[95%CI(2.81,9.49),P0.001]。干預(yù)6個月后,干預(yù)組VSS-SF分?jǐn)?shù)比普通治療組低2.26分[95%CI(0.39,4.12),P=0.020];干預(yù)組眩暈殘障程度分?jǐn)?shù)比普通治療組低5.58分[95%CI(1.19,10.0),P=0.010]。結(jié)論在沒有臨床支持的情況下,前庭康復(fù)網(wǎng)絡(luò)干預(yù)可使社區(qū)老年慢性頭暈患者眩暈及眩暈殘障程度有所降低。這種康復(fù)治療可在社區(qū)醫(yī)療機(jī)構(gòu)中廣泛應(yīng)用。
[Abstract]:Objective vestibular rehabilitation is effective for vertigo caused by vestibular dysfunction. But so far the rehabilitation therapy has been carried out less. The purpose of this study was to investigate the effect of vestibular rehabilitation network intervention program in elderly patients with chronic dizziness in community. Methods this study was a single-center, single-blind randomized controlled trial. Conducted in 54 community health care institutions in southern England. The study looked at people over the age of 50 years from these institutions. Patients with vertigo and aggravated head movement vertigo. Patients were randomly divided into intervention group and general treatment group. The intervention group was given vestibular rehabilitation network intervention [balance training (patients learn vestibular rehabilitation training and cognition through the network). Behavior management strategy (see https://balance.lifeguidehealth.org for details). The general treatment group was given general general treatment. Before intervention, After 3 and 6 months of intervention, a brief vertigo symptom scale (VSS-SF) was used to investigate the degree of vertigo in the patients. The main index of the intervention effect was the VSS-SF score of the patients after 6 months of intervention. Results 66% of them were women. The median age was 67 years old. 250 patients completed the VSS-SF test after 3 months of intervention. The patients completed the VSS-SF test after 6 months of intervention. After 3 months of intervention, the patients completed the VSS-SF test. The VSS-SF score of the intervention group was 2.75 points lower than that of the general treatment group [95CII 1.39 鹵4.12 P0.001], and the score of vertigo and disability in the intervention group was 6.15 points lower than that in the general treatment group. The VSS-SF score of the intervention group was 2.26 points lower than that of the general treatment group [95CII 0.39 鹵4.12 P0.020], and the score of the degree of vertigo disability in the intervention group was 5.58 points lower than that in the general treatment group. Conclusion without clinical support, the score of VSS-SF in the intervention group is 5.58 points lower than that in the general treatment group. The intervention of vestibular rehabilitation network can reduce the degree of vertigo and vertigo disability in the elderly patients with chronic dizziness in community, and this kind of rehabilitation treatment can be widely used in community medical institutions.
【分類號】:R49;R764.3

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