Activity and Participation in Vestibulopathy

目前的前庭康复干预前庭损害(平衡、凝视稳定性和 头晕)。前庭疾病患者的活动度和参与度降低，但在 前庭康复方案。大约40%的前庭疾病患者没有完全康复， 过渡到慢性残疾状态，这往往是由于活动和参与减少造成的，以及。 来自其他人群康复科学的证据表明，恢复充分的活动和参与 与功能活动状态有关，也与几个行为、个人和环境因素有关。 同样，我们怀疑认知、情绪和个人(自信、应对和恐惧回避)因素 是可修改的，可能会影响前庭疾病患者的活动和参与度。目前也不清楚是否 活动和参与度的提高与前庭损伤的修复有关 康复。活动和参与是优化成果和减少污染的重要领域 慢性残疾。这一职业发展奖将确立布鲁克·克拉特博士作为临床科学家的地位 3个主要领域的专业知识：(1)队列设计和分析；(2)定性方法；(3)复杂性 康复干预发展和行为临床试验方法学。克莱特博士已经组装了一个 康复干预措施的制定和实施方面的多学科专家小组(詹妮弗 BRAACH，博士，PT和伊丽莎白·斯基德莫尔，博士，OTR/L)，活动和参与评估以及 流行病学方法(Andrea Rosso，博士，公共卫生硕士)，行为对前庭恢复的影响(杰弗里) 和临床试验方法(Megan Hamm博士和Charity Patterson博士、博士和MSPH)。克拉特博士 将进行一系列研究，以开发一种增强型前庭干预，它将增加电流 前庭康复有针对性地提高活跃度和参与度。她将调查是否存在损害 (平衡、步态、凝视稳定性、头晕、认知和情绪)以及个人因素(自信、应对 技能和恐惧回避)与前庭疾病患者的活动和参与有关(目标1)，以及 她将确定前庭损伤的减少是否与活动和参与度的改善有关 (目标2)。她将使用来自临床医生和患者的利益相关者的意见来确定以下交付特征 改善前庭疾病患者的活动和参与度的最大希望(目标3)。克拉特医生的是 计划开发有效的干预措施，以加强目前的前庭康复解决NCMRR 通过使用多模式方法促进缓解二次条件习得的研究优先事项 前庭可塑性和感觉运动功能。拟议的培训将成为未来R01的基础 前庭强化干预提高活动性和参与性的应用研究 以及前庭疾病患者的生活质量。

Current vestibular rehabilitation intervenes upon vestibular impairments (balance, gaze stability, and dizziness). Activity and participation are reduced in people with vestibulopathy, but are not addressed in vestibular rehabilitation protocols. Approximately 40% of people with vestibulopathy do not fully recover and transition to a state of chronic disability, which often results from reductions in activity and participation, and. Evidence from rehabilitation science within other populations suggest that return to full activity and participation is related to functional mobility status, and also several behavioral, personal, and environmental factors. Similarly, we suspect that cognitive, mood, and personal (confidence, coping, and fear avoidance) factors that are modifiable, may impact activity and participation in people with vestibulopathy. It is also unknown whether improvements in activity and participation are related to remediation of impairments following vestibular rehabilitation. Activity and participation represent important domains to target to optimize outcomes and reduce chronic disability. This career development award will establish Dr. Brooke Klatt as a clinical scientist with expertise in 3 primary domains: (1) cohort design and analysis; (2) qualitative methodology, and (3) complex rehabilitation intervention development and behavioral clinical trial methodology. Dr. Klatt has assembled a multi-disciplinary team of experts in rehabilitation intervention development and implementation (Jennifer Brach, PhD, PT and Elizabeth Skidmore, PhD, OTR/L), activity and participation assessment and epidemiological methods (Andrea Rosso, PhD, MPH), behavioral impacts on vestibular recovery (Jeffrey Staab, MD), and clinical trial methodology (Megan Hamm, PhD and Charity Patterson, PhD, MSPH). Dr. Klatt will conduct a series of studies to develop an enhanced vestibular intervention that will augment current vestibular rehabilitation targeted to improve activity and participation. She will investigate whether impairments (balance, gait, gaze stability, dizziness, cognition, and mood) as well as personal factors (confidence, coping skills, and fear avoidance) are related to activity and participation in people with vestibulopathy (Aim 1), and she will determine if reductions in vestibular impairment is related to improvements in activity and participation (Aim 2). She will use stakeholder input from clinicians and patients to determine the delivery features that show the greatest promise for improving activity and participation in people with vestibulopathy (Aim 3). Dr. Klatt’s is plan to develop effective interventions to enhance current vestibular rehabilitation addresses the NCMRR research priorities to mitigate acquisition of secondary conditions by using a multimodal approach to promote vestibular plasticity and sensorimotor function. The proposed training will be the foundation for a future R01 application examining the efficacy of the enhanced vestibular intervention to improve activity and participation and the quality of life for individuals with vestibulopathy.