Efficacy of electrotactile vestibular substitution in patients with peripheral and central vestibular loss.
Efficacy of electrotactile vestibular substitution in patients with peripheral and central vestibular loss.
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DOI：
10.3233/ves-2007-172-307
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发表时间：
2007
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影响因子：
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通讯作者：
Y. Danilov;M. Tyler;K. Skinner;R. Hogle;P. Bach-y-Rita
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作者：
Y. Danilov;M. Tyler;K. Skinner;R. Hogle;P. Bach-y-Rita
中枢性或外周性前庭功能障碍可显著影响平衡、姿势和步态。我们进行了一项试点研究，以测试在由于外周或中央前庭丧失而导致平衡功能障碍的受试者中使用BrainPort平衡设备进行训练的有效性。BrainPort平衡设备通过电触觉刺激舌头来传输有关患者头部位置的信息。头部位置数据由加速度计检测，并以刺激模式显示在舌头上。这种刺激模式在舌头上向前、向后和横向移动，直接响应头部的运动。该设备的使用者被训练使用这种刺激来调整他们的位置，以保持他们的平衡。28名外周性或中枢性前庭缺失的受试者接受了BrainPort平衡设备的训练，并使用以下标准化的治疗效果定量测量方法进行测试：使用感觉组织测试(SOT)的计算机化动态姿势描记(CDP)、动态步态指数(DGI)、活动特定平衡置信度量表(ABC)和头晕手足量表(DHI)。所有受试者都有慢性平衡问题，除一人外，所有受试者都曾参加过前庭康复治疗。在进入研究时，临床测试的分数与使用BrainPort平衡设备进行训练后的分数进行了比较。我们的结果显示，在平衡、姿势和步态方面都有一致的积极和统计上的显著改善。这些结果超过了通常仅用三到五天的传统平衡训练就能达到的效果。由于这不是一项对照研究，我们无法区分这些改善在多大程度上归因于使用BrainPort平衡设备进行的培训，以及作为BrainPort培训课程的一部分，所有受试者进行的平衡练习。尽管如此，在使用BrainPort平衡设备进行培训后，所有受试者的表现都有了显著的改善，超出了传统前庭康复治疗的预期。
Vestibular dysfunction of either central or peripheral origin can significantly affect balance, posture, and gait. We conducted a pilot study to test the effectiveness of training with the BrainPort balance device in subjects with a balance dysfunction due to peripheral or central vestibular loss. The BrainPort balance device transmits information about the patient's head position via electrotactile stimulation of the tongue. Head position data is sensed by an accelerometer and displayed on the tongue as a pattern of stimulation. This pattern of stimulation moves forward, backward, and laterally on the tongue in direct response to head movements. Users of the device were trained to use this stimulation to adjust their position in order to maintain their balance. Twenty-eight subjects with peripheral or central vestibular loss were trained with the BrainPort balance device and tested using the following standardized quantitative measurements of the treatment effects: Computerized Dynamic Posturography (CDP) using the Sensory Organization Test (SOT), Dynamic Gait Index (DGI), Activities-specific Balance Confidence Scale (ABC), and Dizziness Handicap Inventory (DHI). All subjects had chronic balance problems and all but one had previously participated in vestibular rehabilitation therapy. The scores on the clinical tests upon entry into the study were compared to their scores following training with the BrainPort balance device. Our results exhibit consistent positive and statistically significant improvements in balance, posture and gait. These results exceed what could normally be achieved in three to five days of traditional balance training alone. Since this was not a controlled study, we are unable to distinguish the degree to which these improvements are attributable to training with the BrainPort balance device versus the balance exercises performed by all subjects as a part of the BrainPort training sessions. Nonetheless, after training with the BrainPort balance device, all subjects demonstrated significant improvements in performance beyond what might be expected from conventional vestibular rehabilitation therapy.