Variables Associated With Outcome in Patients With Unilateral Vestibular Hypofunction
Variables Associated With Outcome in Patients With Unilateral Vestibular Hypofunction
复制标题
与单侧前庭功能减退患者的结果相关的变量
DOI：
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发表时间：
2012
影响因子：
4.2
通讯作者：
William R. Delaune
中科院分区：
文献类型：
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作者：
S. Herdman;C. Hall;William R. Delaune
背景。并非所有单侧前庭功能减退（UVH）患者在前庭康复后主观主诉减少，功能改善。目标。识别与UVH患者康复结果密切相关的因素和/或因素组合，并最终可用于开发预测结果的模型。方法。对209例UVH患者的资料进行分析。所有患者都参加了类似的前庭康复（5周的家庭锻炼和每周一次的门诊就诊）。结果测量包括示波器和不平衡的强度、平衡信心、感知残疾、症状干扰活动的时间百分比、步态速度、跌倒风险和动态视力（DVA）。双变量相关和回归分析用于确定基线（治疗前）措施与出院结果之间的关系。结果。主观主诉（如症状强度）的基线测量不能预测身体功能（如步态速度）的改善。同样，身体功能的基线测量也不能预测主观抱怨的改善。某些患者特征，如性别和发病时间，与任何结果无关。大多数合并症不影响预后；然而，焦虑和/或抑郁与较低的平衡信心和较高的出院时症状干扰活动的时间百分比有关。基线DVA和步态速度分别与出院时DVA和步态速度相关。出院时动态步态指数（DGI）受年龄、基线DGI和跌倒史的影响。结论。这些结果为UVH患者的康复提供了见解。治疗师可以使用这些信息来制定对患者结果和治疗优先级的期望。
Background. Not all individuals with unilateral vestibular hypofunction (UVH) have fewer subjective complaints and improved function after vestibular rehabilitation. Objective. To identify factors and/or combinations of factors that are strongly associated with rehabilitation outcome in patients with UVH and that ultimately can be used to develop models to predict outcome. Methods. Data from 209 patients with UVH were analyzed. All patients participated in similar vestibular rehabilitation (5 weeks of home exercises and once-weekly clinic visits). Outcome measures included intensity of oscillopsia and dysequilibrium, balance confidence, perceived disability, percentage of time symptoms interfered with activities, gait speed, fall risk, and dynamic visual acuity (DVA). Bivariate correlation and regression analysis were used to determine relationships between baseline (pretherapy) measures and outcome at discharge. Results. No baseline measure of subjective complaints (eg, symptom intensity) predicted improvement of physical function (eg, gait speed). Similarly, no baseline measure of physical function predicted improvement of subjective complaints. Certain patient characteristics, such as gender and time from onset, were not related to any outcomes. Most comorbidities did not affect outcome; however, anxiety and/or depression were associated with lower balance confidence and higher percentage of time for which symptoms interfered with activities at discharge. Baseline DVA and gait speed were associated with DVA and gait speed at discharge, respectively. Dynamic gait index (DGI) at discharge was affected by age, baseline DGI, and history of falls. Conclusion. These results provide insight into recovery of patients with UVH. Therapists can use this information in the development of expectations for patient outcome and treatment priorities.