A new therapeutic approach for somatosensory tinnitus

体感耳鸣的新治疗方法

• 批准号: 9888971
• 负责人: Sarah Theodoroff
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2021-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9888971
• 关键词: Address; Anxiety; Audiology; Awareness; Belief; Caring; Characteristics; Classification; Clinic; Clinical; Communication; Data; Diagnosis; Discipline; Evaluation; Eye Movements; Financial compensation; Goals; Guidelines; Head; Head and neck structure; Health Personnel; Healthcare; Healthcare Systems; Hearing; Institution; Jaw; Knowledge; Lead; Loudness; Methodology; Methods; Modeling; Movement; Muscle Contraction; Musculoskeletal; Myopathy; Neck; Neurologic; Outcome; Pain; Patient Care; Patients; Perception; Persons; Physical therapy; Pilot Projects; Population; Prevalence; Primary Health Care; Procedures; Protocols documentation; Quality of life; Questionnaires; Reporting; Research; Sampling; Screening Result; Screening procedure; Services; Sleeplessness; Structure; Suggestion; Telephone; Therapeutic; Tinnitus; Trauma; Treatment Effectiveness; Treatment Protocols; United States; Veterans; Visit; Work; base; clinical decision-making; clinical practice; comorbidity; disability; evidence base; health care service; improved; interdisciplinary approach; jaw movement; novel; novel strategies; novel therapeutic intervention; programs; screening; somatosensory; tool

Somatosensory tinnitus is suspected when perceptual characteristics (e.g., pitch and loudness) change immediately following head and neck maneuvers, forceful muscle contractions, or eye or jaw movements. Prevalence estimates range from 60 to 80% of tinnitus patients being able to modulate their tinnitus by manipulating somatic regions of the jaw, head, and neck (Ralli et al, 2017), suggesting somatosensory tinnitus to be common, yet the prevalence of this type of tinnitus in Veterans is unknown. The fact that somatic manipulations can directly influence the tinnitus perception for many patients (Shore, 2011) provides the scientific premise for the proposed research to adapt a non-traditional therapeutic approach (i.e., not usual care) for Veterans with this type of tinnitus, which involves physiotherapy. This research is the first step in achieving our long-term goal to develop a clinical framework that can diagnose, assess, and treat Veterans with somatosensory tinnitus. The proposed research is based on the Cleveland Clinic model which evaluates all tinnitus patients to determine if their tinnitus can be somatically modulated. When somatosensory tinnitus is detected, an individualized physiotherapy program is prescribed. This novel approach to somatosensory tinnitus treatment provides the structure for our pilot study. Results of this study will: i) provide data estimating and describing the prevalence of somatosensory tinnitus in Veterans with tinnitus and ii) generate feasibility data for using an adapted version of Cleveland Clinic's individualized physiotherapy approach to treat Veterans with somatosensory tinnitus. The focus of Year 1 will be adapting the neurological screening exam and physiotherapy procedures used at Cleveland Clinic's Tinnitus Management Clinic for use in Veterans. A phone screening will be conducted to identify Veterans suspected of having somatosensory tinnitus. Based on the phone screening results, 10 Veterans suspected of having somatosensory tinnitus and 10 Veterans whose tinnitus is not suspected to be influenced by somatic maneuvers, will be invited to attend an in-person visit to determine how accurate the phone screening was in identifying Veterans with somatosensory tinnitus (Aim 1). Additionally, another sample of 10 Veterans who can somatically modulate their tinnitus (confirmed by in-person Visit 1) will be invited to participate in the physical therapy portion of this study and attend 3 individualized physiotherapy treatment sessions (Aim 2). Questionnaires will be administered to evaluate the effects and impact of somatosensory tinnitus on quality of life. Outcomes of the proposed work will have clinical impact for patients and health care providers. This research is taking the necessary steps to provide an evidence-based approach to direct clinical decision-making for Veterans with tinnitus. Knowledge learned will be disseminated to healthcare providers in multiple disciplines (e.g., audiology, physical therapy, primary care, etc.) to dispel the belief that “nothing can be done” and raise awareness regarding how best to assess and treat Veterans with tinnitus.

当感知特征（例如，音高和响度）变化 紧接着头部和颈部动作，有力的肌肉收缩，或眼睛或下巴运动。 耳鸣患者中的60%至80%的人能够通过以下方式来调节他们的耳鸣： 操纵下颌、头部和颈部的躯体区域（Ralli et al，2017），提示体感性耳鸣 耳鸣的危害有哪些呢？耳鸣的危害有哪些呢？事实上， 操作可以直接影响许多患者的耳鸣感知（海岸，2011）提供了 所提出的研究采用非传统治疗方法的科学前提（即，不常见 护理）退伍军人与这种类型的耳鸣，其中涉及物理治疗。这项研究是第一步 实现我们的长期目标，开发一个临床框架，可以诊断，评估和治疗退伍军人 耳鸣的症状 这项研究是基于克利夫兰诊所的模型，该模型评估所有耳鸣患者， 确定他们的耳鸣是否可以被身体调节。当检测到体感耳鸣时， 制定个性化的物理治疗方案。耳鸣的治疗方法有哪些？ 为我们的试点研究提供了结构。本研究的结果将：i）提供估计和描述 耳鸣退伍军人中体感性耳鸣的患病率和ii）生成使用 克利夫兰诊所的个性化物理治疗方法的改编版本，以治疗退伍军人 躯体感觉性耳鸣 第一年的重点将是适应神经系统筛查检查和物理治疗程序， 克利夫兰诊所用于退伍军人的耳鸣管理诊所。将进行电话筛选， 耳鸣的危害有哪些？根据手机筛选结果，10 退伍军人怀疑有躯体感觉性耳鸣和10退伍军人的耳鸣是不是怀疑 受躯体动作的影响，将被邀请参加一个亲自访问，以确定如何准确的 电话筛选是在识别退伍军人与体感耳鸣（目的1）。另一个样本 10名退伍军人谁可以身体调节他们的耳鸣（证实在人访视1）将被邀请， 参加本研究的物理治疗部分，并参加3次个体化物理治疗 会议（目标2）。将进行问卷调查，以评估躯体感觉的效果和影响。 耳鸣对生活质量的影响 拟议工作的结果将对患者和医疗保健提供者产生临床影响。本研究 正在采取必要的措施，提供以证据为基础的方法来指导临床决策， 有耳鸣的退伍军人。所学到的知识将传播给多个学科的医疗保健提供者 (e.g.,听力学、物理治疗、初级保健等）破除“无事可做”的信念， 耳鸣的危害有哪些？耳鸣的危害有哪些？