目的 探讨在视觉参与下,前庭功能训练和本体觉训练对老年性后循环缺血引起的眩晕症状和平衡功能的疗效。方法 2016年6月至2018年5月,72例年龄 > 60岁的后循环缺血性眩晕患者随机分成本体组(n = 24)、前庭组(n = 24)和综合组(n = 24)。所有患者均进行常规药物治疗和康复训练,本体组行本体觉训练,前庭组行前庭功能训练,综合组同时进行本体觉训练和前庭功能训练。治疗前和治疗4周后,分别采用眩晕评定量表(DARS)、眩晕残障量表(DHI)和Berg平衡量表(BBS)进行评定,经颅多普勒超声测量基底动脉平均血流速度(Vm),Tetrax平衡仪测量稳定性指数(ST)。结果 治疗后,三组患者的DARS、DHI、BBS评分,Vm和ST均较治疗前显著改善(t > 57.825, P < 0.001),综合组DHI、BBS评分和ST优于本体组和前庭组(P < 0.05),前庭组和综合组Vm和DARS评分优于本体组(P < 0.05)。结论 在视觉参与下,前庭功能训练结合本体觉训练可以进一步减轻老年性后循环缺血引起的眩晕症状,改善平衡功能,提高生活质量。
Objective To observe the effects of vestibular function training and proprioception training on vertigo and balance function after postoperative circulatory ischemia under the visual participation. Methods From June, 2016 to May, 2018, 72 patients with posterior circulation ischemic vertigo aged more than 60 were randomly divided into proprioception group (n = 24), vestibular group (n = 24) and comprehensive group (n = 24). All the patients received routine medicine and rehabilitation training. Moreover, the proprioception group accepted proprioception training, the vestibular group accepted vestibular function training, and the comprehensive group accepted both proprioception training and vestibular function training. They were assessed with Dizziness Assessment Rating Scale (DARS), Dizziness Handicap Inventory (DHI) and Berg Balance Scale (BBS) before and after four weeks of treatment, while the mean velocity (Vm) of blood flow in the basilar artery was measured with transcranial Doppler, and the stability index (ST) was measured with Tetrax. Results The scores of DARS, DHI and BBS, and Vm and ST improved in all the groups after treatment (t > 57.825, P < 0.001). However, the scores of DHI and BBS, and ST improved more in the comprehensive group than in the proprioception group and the vestibular training group (P < 0.05), Vm and score of DARS improved more in the vestibular group and the comprehensive group than in the proprioception group (P < 0.05). Conclusion With the participation of the vision, vestibular function training combined with proprioception training can further alleviate vertigo caused by postoperative circulatory ischemia, and improve balance and quality of life.
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