HABITUATION THERAPY FOR CHRONIC VESTIBULAR DYSFUNCTION

慢性前庭功能障碍的习惯疗法

• 批准号: 3080218
• 负责人: STEVEN A TELIAN
• 金额: $ 8.96万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-05-01 至 1993-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3080218
• 关键词: behavioral habituation /sensitization; chronic disease /disorder; ear disorder diagnosis; ear surgery; electrooculography; exercise; human subject; human therapy evaluation; labyrinth disorder; motion perception; patient care management; physical therapy; posture; proprioception /kinesthesia; statistics /biometry; vertigo; vestibular apparatus

Treatment options for patients with chronic vestibular dysfunction have included observation following diagnostic evaluation, pharmacologic management, and surgery. Basic science investigation suggests that central nervous system compensation for peripheral vestibular symptoms may be counter-productive in patients with vestibular dysfunction. Customized physical exercise which repeatedly exposes the patient to vestibular sensory conflict may enhance recovery, yet this modality is rarely utilized in the United States. Preliminary data suggest that customized vestibular habituation therapy (VHT) is a safe, effective treatment modality. Accessible programs of VHT could provide great relief to patients with considerable disability who lack other treatment options. VHT may also obviate the need for vestibular surgery when continued symptoms are due to lack of compensation rather than ongoing labyrinthine dysfunction. Moreover, this modality could provide a safe, rational, and ethical nonsurgical control treatment for prospective trials of surgical treatment. A three-year clinical investigator development award (CIDA) is proposed. This will include clinical investigations related to VHT addressing the following aims: 1.) To objectify the assessment of patients with chronic vestibular dysfunction. 2) To assess the therapeutic effectiveness of VHT through a prospective, randomized, controlled trial involving patients with chronic vestibular dysfunction. 3) To determine the role of dynamic posturography in VHT by comparing the predictive value of alternative, less expensive methodology in the design of treatment protocols. An extensive program of training in clinical research design and biostatistical analysis is also proposed for the Principal Investigator. This will facilitate the future design and administration of ongoing local and multi-institutional prospective clinical trials to address unanswered questions in the field of neurology, especially those related to vestibular dysfunction.

慢性前庭功能障碍患者的治疗选择有 包括诊断评价后的观察，药理学 管理和手术。 基础科学研究表明， 外周前庭症状的神经系统补偿可能是 对前庭功能障碍的患者产生反作用。 定制 反复使患者暴露于前庭的身体锻炼 感觉冲突可能会促进恢复，但这种方式很少使用 在美国 初步数据表明，定制前庭 习惯化治疗（VHT）是一种安全、有效的治疗方式。 VHT的可行性方案可以为患者提供极大的缓解， 严重残疾，缺乏其他治疗选择。 VHT还可以 当持续的症状是由于以下原因时， 缺乏补偿而不是持续的肾上腺素功能障碍。 此外，这种模式可以提供一种安全，合理， 手术治疗的前瞻性试验的非手术对照治疗。 一个为期三年的临床研究者发展奖（CIDA）被提议。 这将包括与VHT相关的临床研究， 目标：1.）客观评估慢性 前庭功能障碍。 2)评价VHT的治疗效果 通过一项前瞻性、随机、对照试验， 慢性前庭功能障碍 3)确定动态的作用 通过比较体位图在VHT中的预测价值， 在治疗方案的设计中使用昂贵的方法。 在临床研究设计培训的广泛计划， 还建议对主要研究者进行生物统计学分析。 这将有助于今后设计和管理正在进行的地方 和多机构前瞻性临床试验，以解决 神经学领域的问题，特别是与前庭有关的问题， 功能障碍