A Conceptual Framework for the Progression of Balance Exercises in Persons with Balance and Vestibular Disorders.
A Conceptual Framework for the Progression of Balance Exercises in Persons with Balance and Vestibular Disorders.
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发表时间：
2015
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通讯作者：
B. Klatt;W. Carender;Chia-Cheng Lin;S. Alsubaie;C. Kinnaird;K. Sienko;S. Whitney
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作者：
B. Klatt;W. Carender;Chia-Cheng Lin;S. Alsubaie;C. Kinnaird;K. Sienko;S. Whitney
同行评审的文献中几乎没有信息专门指导患有平衡和前庭障碍的人选择运动方式。本研究的目的是为建立进展框架提供依据，并提出前庭障碍患者进行平衡练习的逻辑顺序。我们的初步概念框架是由物理治疗师和工程师组成的多学科团队开发的，他们在治疗前庭疾病方面拥有丰富的经验。平衡练习分为六种不同的类别：静态站立、柔顺表面、重心转移、重心改变、步态和前庭眼反射 (VOR)。通过系统化的文献综述、与物理治疗师和姿势控制专家的访谈和焦点小组讨论，以及对每种练习进行重复试验的试点研究，制定了每个类别的练习进展并按难度顺序进行排名。临床专业知识和经验指导运动进展的决策。人们讨论了数百种运动组合，并且正在进行研究以验证假设的排名。六个运动类别可以纳入平衡训练计划中，并且运动进展框架可用于指导经验不足的练习者制定平衡计划。它还可以帮助临床医生和研究人员在治疗计划或临床试验中设计、开发和推进干预措施。结构化的运动框架有可能最大限度地控制姿势，减少头晕/视眩晕的症状，并为患有前庭疾病的人提供运动进展的“规则”。该概念框架也可能适用于有其他平衡相关问题的人。
There is little information in peer-reviewed literature to specifically guide the choice of exercise for persons with balance and vestibular disorders. The purpose of this study is to provide a rationale for the establishment of a progression framework and propose a logical sequence in progressing balance exercises for persons with vestibular disorders. Our preliminary conceptual framework was developed by a multidisciplinary team of physical therapists and engineers with extensive experience with people with vestibular disorders. Balance exercises are grouped into six different categories: static standing, compliant surface, weight shifting, modified center of gravity, gait, and vestibulo-ocular reflex (VOR). Through a systematized literature review, interviews and focus group discussions with physical therapists and postural control experts, and pilot studies involving repeated trials of each exercise, exercise progressions for each category were developed and ranked in order of degree of difficulty. Clinical expertise and experience guided decision making for the exercise progressions. Hundreds of exercise combinations were discussed and research is ongoing to validate the hypothesized rankings. The six exercise categories can be incorporated into a balance training program and the framework for exercise progression can be used to guide less experienced practitioners in the development of a balance program. It may also assist clinicians and researchers to design, develop, and progress interventions within a treatment plan of care, or within clinical trials. A structured exercise framework has the potential to maximize postural control, decrease symptoms of dizziness/visual vertigo, and provide "rules" for exercise progression for persons with vestibular disorders. The conceptual framework may also be applicable to persons with other balance-related issues.