Sensory Re-training following Orthognathic Surgery

正颌手术后的感觉再训练

• 批准号: 6516647
• 负责人: CEIB PHILLIPS
• 金额: $ 34.56万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-15 至 2006-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6516647
• 关键词: behavior therapy; clinical trials; human subject; human therapy evaluation; oral pharyngeal surgery; patient oriented research; perception; postoperative complications; sensory disorders; touch

DESCRIPTION: (provided by the applicant) Abnormal facial sensation has a negative impact on patient's oral behaviors and may adversely affect a patient's quality of life if the altered sensation persists. Many patients with abnormal sensations retain some sensory function and do not develop chronic pain, and for those individuals there are no currently evidence-based noninvasive therapies. The goal of this project is to evaluate sensory re-training, a rehabilitative therapy that offers significant potential for patients who experience impaired sensory function regardless of the cause. This behavior therapy approach has been used with substantial clinical success with hand injury patients since the 1970s. Re-training appears to enhance central reorganization of the impulses from an injured sensory nerve to the cerebral cortex so that the altered sensory signals can be interpreted and translated into functionally meaningful motor functions. Sensory re-training will be compared to a placebo jaw-opening exercise in a single blind, randomized two-arm parallel group stratified block clinical trial, using orthognathic surgery patients as subjects. Orthognathic surgery patients offer an uncompromised model for the evaluation of new rehabilitative therapies. These healthy patients, treated to correct dentofacial deformity, present for surgery with no neurosensory impairment, but yet routinely experience substantial alterations in facial sensation following the surgical procedure. The effcts of sensory re-training will be evaluated using three types of outcomes: patient-centered measures to assess the magnitude of the negative effect of altered sensation after surgery and the recovery time needed to reach little or no negative effect; neurosensory behavior measures to assess the patient's ability to learn alternate cues for touch perception and discrimination; and a conventional neurosensory contact threshold measure to assess the actual deficit. Our primary focus will be on the patient's perception of the negative impact of altered sensation on daily life.

描述：（由申请人提供）面部感觉异常 对患者的口腔行为产生负面影响，并可能对 如果感觉改变持续存在，患者的生活质量就会受到影响。许多患者患有 异常感觉保留了一些感觉功能并且不会发展为慢性 疼痛，对于这些人来说，目前没有基于证据的 无创疗法。该项目的目标是评估感官 再训练，一种康复疗法，为康复提供了巨大的潜力 无论原因如何，感觉功能受损的患者。这 行为治疗方法已在临床上取得了巨大的成功 自 20 世纪 70 年代以来手部受伤患者。再培训似乎可以增强中枢能力 重组从受伤的感觉神经到大脑的冲动 皮层，以便可以解释和翻译改变的感觉信号 转化为具有功能意义的运动功能。 感觉再训练将与安慰剂张开下巴的练习进行比较 单盲、随机双臂平行组分层区组临床 试验以正颌手术患者为受试者。正颌手术 患者为评估新的康复治疗提供了一个不折不扣的模型 疗法。这些健康的患者接受了矫正牙面畸形的治疗， 接受手术时没有神经感觉障碍，但仍是常规的 手术后面部感觉发生显着变化 程序。感觉再训练的效果将使用三个指标进行评估 结果类型：以患者为中心的措施来评估结果的严重程度 手术后感觉改变的负面影响以及所需的恢复时间 达到很少或没有负面影响；神经感觉行为测量来评估 患者学习触觉感知替代线索的能力 歧视;和传统的神经感觉接触阈值测量 评估实际赤字。我们的主要关注点是患者的 感知改变对日常生活的负面影响。