评估在社区人群中整合前庭康复与认知行为疗法治疗慢性头晕的有效性：一项随机对照试验
Evaluating the Effectiveness of an Integrated Treatment of Vestibular Rehabilitation and Cognitive Behavior Therapy for Chronic Dizziness in a Community-Based Population: A Randomized Controlled Trial.
文献信息
| PMID | 42713988 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Lene Kristiansen |
| 作者单位 | Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway. |
| 期刊 | Physical therapy |
| SCI 分区 | Q1 |
| IF | 4.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
重要性： 慢性头晕在初级保健中很常见。认知策略联合前庭康复（VR）可能增强疗效，但具有长期随访的随机对照试验证据有限。
目的： 目的是评估在慢性头晕个体中，整合前庭康复与认知行为策略的团体干预（VR-CBT）是否比单次简短前庭干预（BI-VR）提供额外获益。
设计： 开展了一项单盲、随机对照试验，在基线以及6个月和12个月后进行评定。
场所： 研究在初级保健场所进行。
参与者： 研究纳入105名患有慢性头晕的成人。
干预/暴露： 所有参与者在分配至干预组或对照组之前均接受BI-VR。干预包括一个8次课程的团体项目（VR-CBT），并与电话随访（对照）进行比较。
主要结局和测量指标： 主要结局为头晕相关残障（DHI-N）和偏好步速，此外还有若干次要结局。组间差异使用线性混合效应模型并采用Holm-Bonferroni校正进行估计。
结果： 两组的DHI-N随时间均有改善，6个月（6.3分，95% CI = -12.7至0.2）或12个月（7.0分，95% CI = -13.3至-0.6）时组间差异均无统计学显著性。6个月（MD = 0.05 m/s，95% CI = -0.03至0.13）或12个月（MD = 0.07 m/s，95% CI = -0.01至0.15）时偏好步速均未观察到组间差异。在两次随访中均观察到头部运动后头晕强度的组间差异。未发现其他一致的组间差异。
结论： 两组在12个月内均显示头晕相关残障持续改善，主要结局无统计学显著的组间差异。需要进一步研究以阐明联合前庭康复与认知行为策略的实用性。
相关性： 两种方法均与随时间改善相关，而VR-CBT的附加价值仍不确定。
英文摘要
IMPORTANCE: Chronic dizziness is common in primary care. Cognitive strategies combined with vestibular rehabilitation (VR) may enhance outcomes, but evidence from randomized controlled trials with long-term follow-up is limited.
OBJECTIVE: The objective was to evaluate whether a group-based intervention integrating vestibular rehabilitation and cognitive behavioral strategies (VR-CBT) provides added benefit beyond a single-session brief vestibular intervention (BI-VR) in individuals with chronic dizziness.
DESIGN: A Single-blinded, randomized controlled trial with assessments at baseline, and after 6 and 12 months was conducted.
SETTING: The study was conducted in a primary care setting.
PARTICIPANTS: One hundred five adults with chronic dizziness were included in the study.
INTERVENTION/EXPOSURE: All participants received BI-VR prior to allocation to either intervention or control group. The intervention comprised of an 8-session group-based program (VR-CBT) and was compared to telephone follow-up (control).
MAIN OUTCOME(S) AND MEASURE(S): Primary outcomes were dizziness-related handicap (DHI-N) and preferred gait speed, in addition to several secondary outcomes. Between-group differences were estimated using linear mixed-effects models with Holm-Bonferroni adjustment.
RESULTS: DHI-N improved in both groups over time with no statistically significant between-group differences 6 months (6.3 points, 95% CI = -12.7 to 0.2) or 12 months (7.0 points, 95% CI = -13.3 to -0.6). No between-group differences were observed in preferred gait speed at 6 months (MD = 0.05 m/s, 95% CI = -0.03 to 0.13) or 12 months (MD = 0.07 m/s, 95% CI = -0.01 to 0.15). A between-group difference was observed for dizziness intensity after head movement at both follow-ups. No other consistent between-group differences were found.
CONCLUSION: Both groups showed sustained improvement in dizziness-related handicap over 12 months, with no statistically significant between-group differences in the primary outcomes. Further research is needed to clarify the usefulness of combined vestibular rehabilitation and cognitive behavioral strategies.
RELEVANCE: Both approaches were associated with improvement over time, while the added value of VR-CBT remains uncertain.