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.
XU Ru-wei
,
FAN You-qiang
,
WU Di
,
JIANG Peng
,
XU Lin
,
XU Liang
,
MA Ming
,
JIANG Ya-na
. Effects of Vestibular Function Rehabilitation Combined with Proprioceptive Sense Training on Senile Posterior Circulation Ischemic Vertigo[J]. Chinese Journal of Rehabilitation Theory and Practice, 2018
, 24(11)
: 1333
-1337
.
DOI: 10.3969/j.issn.1006-9771.2018.11.015
[1] 陈继欣,陈淑琪,刘荣. 针刺对后循环缺血性眩晕疗效的Meta分析[J]. 中国老年学杂志, 2018, 38(14): 3329-3333.
[2] 张振芳,司秋霞,黄静,等. 高压氧治疗小血管病变导致的后循环缺血性眩晕的疗效观察[J]. 临床医药实践, 2016, 25(5): 332-334.
[3] 何菊,张怀亮. 后循环缺血性眩晕的中西医研究进展[J]. 中国中医基础医学杂志, 2018, 24(6): 871-874.
[4] Yoo MH, Yang CJ, Kim SA, et al.Efficacy of steroid therapy based on symptomatic and functional improvement in patients with vestibular neuritis: a prospective randomized controlled trial[J]. Eur Arch Otorhinolaryngol, 2017, 274(6): 2443-2451.
[5] Bayat A, Saki N.Effects of vestibular rehabilitation interventions in the elderly with chronic unilateral vestibular hypofunction[J]. Iran J Otorhinolaryngol, 2017, 29(93): 183-188.
[6] 中国后循环缺血专家共识组. 中国后循环缺血的专家共识[J]. 中华内科杂志, 2006, 45(9): 786-787.
[7] Della-Morte D, Rundek T.Dizziness and vertigo[J]. Front Neurol Neurosci, 2012, 30: 22-25.
[8] 岳磊,张文慧. 丁苯酞联合纳洛酮治疗老年后循环缺血性眩晕症效果及安全性分析[J]. 中国临床新医学, 2018, 11(4): 378-381.
[9] 何俐. 眩晕与后循环缺血[J]. 中华保健医学杂志, 2014, 16(3): 171-173.
[10] 侯炳辉,张晨,赵仁亮,等. CT血管造影评价后循环缺血性眩晕的价值[J]. 青岛大学医学院学报, 2010, 46(2): 163-165.
[11] Kim JS, Lee H.Vertigo due to posterior circulation stroke[J]. Semin Neurol, 2013, 33(3): 179-184.
[12] Chu CH, Liu CJ, Lin LY, et al.Migraine is associated with an increased risk for benign paroxysmal positional vertigo: a nationwide population-based study[J]. J Headache Pain, 2015, 16(1): 1-7.
[13] 谢欣,孙强,李志贤. 椎基底动脉血管异常与老年良性阵发性位置性眩晕患者临床特征的相关性[J]. 安徽医学, 2017, 38(2): 185-188.
[14] 林细康,季晓林,罗高青,等. 后循环缺血性眩晕患者的前庭功能变化[J]. 中国耳鼻咽喉头颈外科, 2016, 23(12): 686-690.
[15] 刘海宝. 老年眩晕临床分析[J]. 临床医药文献电子杂志, 2016, 3(9): 1611-1612.
[16] Davalos-Bichara M, Agrawal Y.Normative results of healthy older adults on standard clinical vestibular tests[J]. Otol Neurotol, 2014, 35(2): 297-300.
[17] Li C, Layman AJ, Geary R, et al.Epidemiology of vestibulo-ocular reflex function: data from the Baltimore Longitudinal Study of Aging[J]. Otol Neurotol, 2015, 36(2): 267-272.
[18] 刘旭辉,冯亚群,郑常龙. 老年人眩晕的流行病学调查与相关因素分析[J]. 临床医学工程, 2013, 20(7): 895-896.
[19] Jeong J, Jung J, Lee JM, et al.Effects of saccular function on recovery of subjective dizziness after vestibular rehabilitation[J]. Otol Neurotol, 2017, 38(7): 1017-1023.
[20] 李瑞香,戢小军,高修明. 前庭康复治疗在中枢性眩晕患者中的疗效观察[J]. 中华耳科学杂志, 2017, 15(6): 675-678.
[21] Pal S, Rosengren SM, Colebatch JG.Stochastic galvanic vestibular stimulation produces a small reduction in sway in Parkinson's disease[J]. J Vestib Res, 2009, 19(4): 137-142.
[22] Oliveira CB, Medeiros ÍRT, Greters MG, et al.Abnormal sensory integration affects balance control in hemiparetic patients within the first year after stroke[J]. Clinics, 2011, 66(12): 2043-2048.
[23] Fitzpatrick RC, Watson SR.Passive motion reduces vestibular balance and perceptual responses[J]. J Physiol, 2015, 593(10): 2389-2398.
[24] 韩英博,彭俊阳,姚建华. 眩晕的病因分类与规范诊治[J]. 中国老年学, 2015, 35(9): 2590-2592.
[25] Chen IC, Cheng PT, Chen CL, et al.Effects of balance training on hemiplegic stroke patients[J]. J Chang Gung Med, 2002, 25(9): 583-590.
[26] 张丽,瓮长水,王秋华,等. 前庭感觉、本体感觉及视觉功能对老年人跌倒风险影响的因素分析[J]. 中国康复理论与实践, 2010, 16(1): 16-18.
[27] 付奕,谢丽君,丘卫红,等. 感觉系统障碍对脑卒中平衡能力的影响[J]. 中国康复理论与实践, 2011, 17(10): 983-985.
[28] Iwasaki S, Yamasoba T.Dizziness and imbalance in the elderly: age-related decline in the vestibular system[J]. Aging Dis, 2015, 6(1): 38-47.
[29] 王秀阳,王伟,许莉敏,等. 老年人身体平衡能力的影响因素及改善方法[J]. 中国康复医学杂志, 2015, 30(6): 631-634.
[30] 段林茹,郑洁皎,徐国会,等. 感觉的平衡维持优先策略研究[J]. 中国康复理论与实践, 2017, 23(11): 1241-1244.
[31] 焦丽琴,元小冬,吴小英,等. 前庭刺激对后循环血流的影响[J]. 现代电生理学杂志, 2007, 14(1): 9-11.
