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）变化时，怀疑是气压耳鸣 立即跟随头部和颈部操纵，有力的肌肉收缩或眼睛或下颌运动。 患病率估计值在60％至80％的耳鸣患者中能够通过 操纵下颌，头部和颈部的躯体区域（Ralli等，2017），暗示了体感的耳鸣 很常见，但是退伍军人中这种耳鸣的流行率尚不清楚。躯体的事实 操纵可以直接影响许多患者的耳鸣感知（Shore，2011年） 拟议研究的科学前提是适应非传统治疗方法（即，不是通常 护理）对这种类型的耳鸣的退伍军人，涉及物理疗法。这项研究是第一步 实现我们的长期目标，以开发可以诊断，评估和治疗退伍军人的临床框架 带有体感耳鸣。 拟议的研究基于克利夫兰诊所模型，该模型将所有耳鸣患者评估为 确定他们的耳鸣是否可以体面调节。当检测到体感耳鸣时 规定了个性化的理疗计划。这种新颖的细感耳鸣治疗方法 为我们的试点研究提供了结构。这项研究的结果将：i）提供数据估计和描述 在具有耳鸣和ii的退伍军人中，体感的细胞核患病率和II）生成可行性数据 克利夫兰诊所的个性化物理治疗方法的改编版，以治疗退伍军人 体感耳鸣。 第1年的重点将是调整使用的神经系统筛查检查和物理治疗程序 克利夫兰诊所的耳鸣管理诊所用于退伍军人。将进行电话筛查 识别怀疑具有体感耳鸣的退伍军人。根据电话筛选结果，10 退伍军人怀疑没有怀疑耳鸣的10名退伍军人和10名退伍军人 受躯体演习的影响，将邀请参加面对面的访问，以确定 电话筛选是在识别具有体感耳鸣的退伍军人（AIM 1）。另外，另一个样本 可以邀请10名可以体面调节耳鸣的退伍军人（通过面对面的访问1）将被邀请到 参加本研究的物理疗法部分，并参加3种个性化的物理治疗 会议（目标2）。将对问卷进行调查以评估体感的影响和影响 耳鸣关于生活质量。 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。这项研究 是否正在采取必要的步骤来提供基于证据的方法来直接临床决策 带有耳鸣的退伍军人。所学知识将被传播给多个学科的医疗保健提供者 （例如听力学，物理疗法，初级保健等），以消除“无能为力”并提高的信念 关于如何最好地评估和对待老兵用耳鸣的意识。