Effectiveness of Conventional Versus Virtual Reality-Based Balance Exercises in Vestibular Rehabilitation for Unilateral Peripheral Vestibular Loss: Results of a Randomized Controlled Trial
Effectiveness of Conventional Versus Virtual Reality-Based Balance Exercises in Vestibular Rehabilitation for Unilateral Peripheral Vestibular Loss: Results of a Randomized Controlled Trial
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DOI：
10.1016/j.apmr.2015.02.032
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发表时间：
2015-07-01
影响因子：
4.3
通讯作者：
McConn-Walsh, Rory
中科院分区：
文献类型：
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作者：
Meldrum, Dara;Herdman, Susan;McConn-Walsh, Rory
目的：在单侧外周前庭功能丧失（UVL）患者的前庭康复过程中，比较基于虚拟现实的平衡练习与传统平衡练习的有效性。设计：评估者盲法随机对照试验。设置：两家急性护理大学教学医院。参与者：UVL患者（N=71），有头晕/眩晕、步态和平衡障碍。干预措施：UVL患者被随机分配接受6周的传统（n=36）或基于虚拟现实（n=35）的平衡练习前庭康复。基于虚拟现实的组收到了一个现成的虚拟现实游戏系统，用于家庭锻炼，而传统组收到了一个泡沫平衡垫。治疗包括每周一次的物理治疗师和每日家庭锻炼program.Main结果措施：主要结果是自我首选的步态速度。次要结局包括其他步态参数和任务、感觉组织测试（SOT）、动态视力、医院焦虑和抑郁量表、前庭康复益处问卷和活动平衡信心问卷。前庭康复的主观经验进行了测量与questionnaire.Results：两组改善，但有没有干预后组之间的步态速度的显着差异（平均差异，-.03米/秒，95%置信区间[CI]，-.09至.02米/秒）。两组之间的SOT评分（平均差异为0.82%; 95%CI为-5.00%至6.63%）或任何其他次要结局也无显著差异（P> 0.05）。在两组中，坚持锻炼的比例都很高（相似于77%），但基于虚拟现实的组报告了更多的乐趣（P=.001），更少的困难（P=.009）和更少的疲劳（P=.03）平衡练习。在6个月，有没有显着的组间差异，在物理outcome.Conclusions：虚拟现实为基础的平衡练习前庭康复期间进行的前庭康复并不上级传统的平衡练习，但可能提供一个更愉快的方法，再培训平衡后，单方面外周前庭损失。(C)2015年美国康复医学大会
Objective: To compare the effectiveness of virtual reality based balance exercises to conventional balance exercises during vestibular rehabilitation in patients with unilateral peripheral vestibular loss (UVL).Design: Assessor-blind, randomized controlled trial.Setting: Two acute care university teaching hospitals.Participants: Patients with UVL (N=71) who had dizziness/vertigo, and gait and balance impairment.Interventions: Patients with UVL were randomly assigned to receive 6 weeks of either conventional (n=36) or virtual reality based (n=35) balance exercises during vestibular rehabilitation. The virtual reality-based group received an off-the-shelf virtual reality gaming system for home exercise, and the conventional group received a foam balance mat. Treatment comprised weekly visits to a physiotherapist and a daily home exercise program.Main Outcome Measures: The primary outcome was self-preferred gait speed. Secondary outcomes included other gait parameters and tasks, Sensory Organization Test (SOT), dynamic visual acuity, Hospital Anxiety and Depression Scale, Vestibular Rehabilitation Benefits Questionnaire, and Activities Balance Confidence Questionnaire. The subjective experience of vestibular rehabilitation was measured with a questionnaire.Results: Both groups improved, but there were no significant differences in gait speed between the groups postintervention (mean difference, -.03m/s; 95% confidence interval [CI], -.09 to .02m/s). There were also no significant differences between the groups in SOT scores (mean difference,.82%; 95% CI, -5.00% to 6.63%) or on any of the other secondary outcomes (P>.05). In both groups, adherence to exercise was high (similar to 77%), but the virtual reality based group reported significantly more enjoyment (P=.001), less difficulty with (P=.009) and less tiredness after (P=.03) balance exercises. At 6 months, there were no significant between-group differences in physical outcomes.Conclusions: Virtual reality based balance exercises performed during vestibular rehabilitation were not superior to conventional balance exercises during vestibular rehabilitation but may provide a more enjoyable method of retraining balance after unilateral peripheral vestibular loss. (C) 2015 by the American Congress of Rehabilitation Medicine