Sensory Re-training following Orthognathic Surgery

正颌手术后的感觉再训练

• 批准号: 6758504
• 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/6758504
• 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）异常面部感觉具有 对患者口服行为的负面影响，可能会对 如果改变的感觉持续存在，患者的生活质量。许多患者 异常感觉保留了一些感官功能，并且不会发展慢性 痛苦，对于那些人目前没有证据 无创疗法。该项目的目的是评估感官 重新训练，一种康复疗法，可为 无论原因如何，都有感觉功能受损的患者。这 行为疗法方法已通过 自1970年代以来手动受伤患者。重新训练似乎增强了中心 从受伤的感觉神经到大脑的冲动重组 皮质，以便可以解释和翻译改变的感觉信号 进入功能有意义的电机功能。 感官重新训练将与安慰剂下巴练习进行比较 单一盲，随机的两臂平行组分层临床 试验，使用正牙手术患者作为受试者。牙文手术 患者提供了一个毫不妥协的模型，用于评估新的康复性 疗法。这些健康的患者，治疗以纠正牙本质畸形， 在没有神经感觉障碍的情况下进行手术，但仍例行 手术后经历面部感觉的实质性改变 程序。感觉重新训练的效果将使用三个 结果类型：以患者为中心的措施评估 手术后感觉改变和所需的恢复时间的负面影响 几乎没有或没有负面影响；神经感觉行为措施评估 患者学习触摸知觉的替代线索的能力和 歧视;以及常规的神经感觉接触阈值量度 评估实际赤字。我们的主要重点将放在患者的 感知改变感觉对日常生活的负面影响。