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目的前庭康复治疗对由前庭功能障碍所致的眩晕来说比较有效,但迄今为止这种康复治疗的开展还较少。本研究旨在探讨前庭康复网络干预项目在社区老年慢性头晕患者中的效果。方法本项为单中心、单盲的随机对照试验,在英格兰南部54家社区医疗机构开展。研究对象为来自这些机构的年龄≥50岁、患有眩晕并头部运动眩晕加重的患者。患者被随机分为干预组和普通治疗组。干预组给予前庭康复网络干预[平衡训练(患者通过网络学习前庭康复训练及认知行为管理策略),详细内容见https://balance.lifeguidehealth.org],普通治疗组给予普通全科治疗。在干预前、干预3个月及6个月后,采用简明眩晕症状量表(VSS-SF)对患者的眩晕程度进行调查。干预效果的主要评估指标为干预6个月后的VSS-SF分数。结果共纳入296例患者,其中66%为女性,中位年龄为67岁。250例(84%)患者在干预3个月后完成了VSS-SF测评,230例(78%)患者在干预6个月后完成了VSS-SF测评。干预3个月后,干预组VSS-SF分数比普通治疗组低2.75分[95%CI(1.39,4.12),P<0.001];干预组眩晕残障程度分数比普通治疗组低6.15分[95%CI(2.81,9.49),P<0.001]。干预6个月后,干预组VSS-SF分数比普通治疗组低2.26分[95%CI(0.39,4.12),P=0.020];干预组眩晕残障程度分数比普通治疗组低5.58分[95%CI(1.19,10.0),P=0.010]。结论在没有临床支持的情况下,前庭康复网络干预可使社区老年慢性头晕患者眩晕及眩晕残障程度有所降低。这种康复治疗可在社区医疗机构中广泛应用。
Purpose The vestibular rehabilitation is more effective in treating dizziness caused by vestibular dysfunction, but so far this type of rehabilitation has been less developed. The purpose of this study was to investigate the effect of vestibular rehabilitation network intervention in elderly patients with chronic dizziness in the community. Methods This single-center, single-blind, randomized controlled trial was conducted in 54 community health facilities in southern England. Participants were those from these institutions who were ≥50 years of age with dizziness and aggravated head movement. Patients were randomly divided into intervention group and general treatment group. The intervention group was given veterinary rehabilitation network interventions [balance training (patients learning via veterinary rehabilitation training and cognitive behavioral strategies via internet), see https://balance.lifeguidehealth.org for details], and general treatment subjects were given general general practice. Patients were assessed for vertigo using the Concise Vertigo Symptom Inventory (VSS-SF) at 3 and 6 months after intervention. The main assessment of the effect of intervention was the VSS-SF score after 6 months of intervention. Results A total of 296 patients were enrolled, 66% of whom were women, with a median age of 67 years. In 250 patients (84%), VSS-SF was completed 3 months after intervention and 230 patients (78%) completed VSS-SF after 6 months of intervention. After intervention for 3 months, the scores of VSS-SF in the intervention group were 2.75 points lower than those in the normal treatment group (95% CI 1.39, 4.12, P <0.001) CI (2.81, 9.49), P <0.001]. After intervention for 6 months, the scores of VSS-SF in the intervention group were 2.26 points lower than those in the normal treatment group (95% CI 0.39, 4.12, P = 0.020) CI (1.19, 10.0), P = 0.010]. Conclusions In the absence of clinical support, vestibular rehabilitation network intervention may reduce the degree of dizziness and vertigo disability in elderly patients with chronic dizziness. This kind of rehabilitation treatment can be widely used in community medical institutions.