Vestibular rehabilitation following mild traumatic brain injury
Vestibular rehabilitation following mild traumatic brain injury
复制标题
DOI：
10.3233/nre-130874
复制
发表时间：
2013-01-01
影响因子：
2
通讯作者：
Kelly, Jennifer L.
中科院分区：
文献类型：
--
作者：
Gurley, James M.;Hujsak, Bryan D.;Kelly, Jennifer L.
简介：眩晕、头晕和身体失衡是脑震荡后常见的复杂症状。脑震荡后的早期代谢变化可能导致损伤和症状的恶化，从一开始就没有得到适当的处理。当症状不能自发恢复时，熟练的前庭康复可以是一种有效的方式，试图使个体的前庭反应正常化。目的：本综述的目的是评估目前和公认的方法可用于熟练的临床医生量化和治疗脑震荡后前庭功能障碍。将审查发病率和预后指标以及恢复的常见障碍。总结：脑震荡后的前庭康复使用了与单纯外周病理治疗相似的工具和技术。临床医生不仅要对何时以及为什么需要进行某些锻炼有扎实的了解，而且要愿意接受在这一人群中可能需要减少锻炼的事实。由于轻度创伤性脑损伤后的系统损伤可能包括外周和中枢结构，因此治疗的持续时间和恢复时间可能会延长。包括认知和行为问题、视觉感知功能障碍、代谢功能障碍和自主神经功能障碍在内的合并症可能会阻碍传统前庭康复方法的有效性。由于成功的治疗不会在真空中发生，与其他精通治疗这些共病问题的学科密切合作将有助于个人获得最佳康复。结论：前庭康复是治疗脑震荡后头晕、眩晕和失衡的有效方式。仔细考虑损伤的敏锐度，以及对合并症的有效管理将优化结果。
INTRODUCTION: Vertigo, dizziness, and imbalance are a symptom complex that is commonly found following concussion. Early metabolic changes following concussion may lead to worsening of the injury and symptoms in individuals not properly managed from the outset. When symptoms do not recover spontaneously, skilled vestibular rehabilitation can be an effective modality in an attempt to normalize the individual's vestibular responses.PURPOSE: The purpose of this review is to appraise the current and accepted methods available to the skilled clinician in quantifying and treating vestibular dysfunction following concussion. Incidence and prognostic indicators will be reviewed along with common barriers to recovery.SUMMARY: Vestibular Rehabilitation following concussion utilizes similar tools and techniques employed when treating those solely with peripheral pathology. The clinician must not only have a solid understanding of when and why certain exercises are required, but also be willing to accept that less exercise may be indicated in this population. As injury to the system following mild traumatic brain injury can include both peripheral and central structures, the duration of therapy and the time to recovery may be prolonged. Co-morbidities including cognitive and behavioral issues, visual-perceptual dysfunction, metabolic dysfunction, and autonomic dysfunction may hamper the effectiveness of the traditional Vestibular Rehabilitation approach. As successful treatment does not occur in a vacuum, working closely with other disciplines well versed in treating these co-morbid issues will help the individual to obtain optimal recovery.CONCLUSION: Vestibular Rehabilitation is an effective modality for managing dizziness, vertigo, and imbalance following concussion. Careful consideration of the acuity of the injury, along with effective management of co-morbid conditions will optimize the result.