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 包括诊断评估后的观察、药理学 管理和手术。 基础科学研究表明，中央 神经系统对周围前庭症状的代偿可能是 对于前庭功能障碍的患者会适得其反。 定制 反复使患者接触前庭的体育锻炼 感觉冲突可能会促进康复，但很少使用这种方式 在美国。 初步数据表明，定制前庭 习惯疗法（VHT）是一种安全、有效的治疗方式。 VHT 的无障碍计划可以为患有以下疾病的患者提供极大的缓解 缺乏其他治疗选择的严重残疾。 VHT 还可以 当持续症状是由于以下原因导致时，无需进行前庭手术 缺乏代偿而不是持续的迷路功能障碍。 此外，这种方式可以提供安全、合理、合乎道德的方式。 非手术对照治疗用于手术治疗的前瞻性试验。 提议设立为期三年的临床研究者发展奖（CIDA）。 这将包括与 VHT 相关的临床研究，解决 以下目标： 1.) 客观化慢性病患者的评估 前庭功能障碍。 2) 评估VHT的治疗效果 通过一项涉及患有以下疾病的患者的前瞻性、随机、对照试验 慢性前庭功能障碍。 3）确定作用动态 通过比较替代方案、更少方案的预测价值，VHT 中的姿势描记法 治疗方案设计中的昂贵方法。 临床研究设计和培训方面的广泛培训计划 还建议首席研究员进行生物统计分析。 这将有利于未来正在进行的本地项目的设计和管理 和多机构前瞻性临床试验来解决未解答的问题 神经病学领域的问题，特别是与前庭相关的问题 功能障碍。