Activity and Participation in Vestibulopathy

目前的前庭康复干预前庭损伤（平衡，凝视稳定性， 头晕）。活动和参与减少的人与前庭，但没有解决， 前庭康复方案大约40%的前庭病患者不能完全康复， 向慢性残疾状态过渡，这通常是由于活动和参与减少造成的。 来自其他人群康复科学的证据表明， 与功能性活动状态有关，也与一些行为、个人和环境因素有关。 同样，我们怀疑，认知，情绪和个人（信心，应对和恐惧回避）因素， 是可以改变的，可能会影响前庭病患者的活动和参与。也不知道是否 活动和参与的改善与前庭功能障碍的修复有关。 康复活动.活动和参与是优化成果和减少 慢性残疾这个职业发展奖将建立博士布鲁克Klatt作为一个临床科学家， 在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 康复干预开发和行为临床试验方法。克拉特博士已经组织了一个 康复干预开发和实施的多学科专家团队（Jennifer Brach博士，PT和Elizabeth斯基德莫尔博士，OTR/L），活动和参与评估， 流行病学方法（Andrea罗索，PhD，MPH），行为对前庭恢复的影响（Jeffrey Staab，MD）和临床试验方法学（Megan哈姆，PhD和Charity Patterson，PhD，MSPH）。克拉特医生 将进行一系列研究，以开发一种增强的前庭干预， 前庭康复旨在改善活动和参与。她将调查是否有损伤 （平衡、步态、凝视稳定性、头晕、认知和情绪）以及个人因素（信心、应对 技能和恐惧回避）与前庭病患者的活动和参与有关（目标1）， 她将确定前庭损伤的减少是否与活动和参与的改善有关， (Aim 2）。她将使用来自临床医生和患者的利益相关者输入，以确定显示 改善前庭病患者活动和参与的最大希望（目标3）。克拉特医生 制定有效干预措施以加强当前前庭康复的计划解决了NCMRR问题 研究优先事项，以减轻收购的次要条件，通过使用多模式的方法，以促进 前庭可塑性和感觉运动功能。建议的培训将是未来R 01的基础 检查增强前庭干预改善活动和参与的功效的应用 以及前庭病患者的生活质量。

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.