传统与虚拟现实前庭康复对特定学习障碍儿童平衡与视觉运动技能的影响：一项随机对照试验

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中文摘要

目的： 本研究旨在确定特定学习障碍（SLD）儿童与典型发育同龄人相比是否存在前庭和平衡功能损害，并评估传统和虚拟现实（VR）前庭康复在改善平衡表现、前庭功能、视觉运动整合及学习相关结局方面的疗效。
方法： 这项随机对照研究纳入63名7-12岁儿童：42名SLD儿童和21名典型发育儿童作为对照。所有参与者均使用计算机化动态姿势描记法和视频眼震图（VNG）进行前庭和平衡表现的基线评估。SLD儿童被随机分配至传统或基于VR的前庭康复组，每周两次，持续8周。康复组在干预后重复进行前庭和平衡评估。使用数学、阅读和写作评估量表（MOYA）以及Bender-Gestalt视觉运动知觉测验（BGT）评估SLD儿童康复前后的学业表现和知觉-运动整合。
结果： 在基线时，与对照组相比，SLD儿童在感觉组织测验（SOT）、适应测验（AT）和稳定极限（LOS）方面表现出显著较差的平衡表现（p < .05），而VNG结果在组间无差异（p > .05）。康复后，两个干预组在SOT、AT和LOS参数方面均显示出显著改善（p < .05）。MOYA和BGT评分也显著改善（p < .001）。基于VR的康复组在前庭相关平衡评分和向左扫视速度方面比传统组表现出更大的改善（p < .05）。
结论： 前庭康复可能改善SLD儿童的平衡和功能结局。传统和基于VR的方法似乎均有益，其中基于VR的康复在选定的前庭和眼动测量方面显示出进一步改善的趋势。这些发现表明，包括VR辅助方法在内的前庭康复可能代表该人群的一种补充干预，但仍需进一步研究以阐明长期效果。

英文摘要

PURPOSE: This study aimed to determine whether children with specific learning disorders (SLDs) exhibit impairments in vestibular and balance functions compared with typically developing peers and to assess the efficacy of traditional and virtual reality (VR)-based vestibular rehabilitation in improving balance performance, vestibular function, visual-motor integration, and learning-related outcomes.
METHOD: This randomized controlled study included 63 children aged 7-12 years: 42 children with SLD and 21 typically developing children as controls. All participants underwent baseline assessment of vestibular and balance performance using computerized dynamic posturography and videonystagmography (VNG). Children with SLD were randomly assigned to either a traditional or a VR-based vestibular rehabilitation group, administered twice weekly for 8 weeks. Vestibular and balance assessments were repeated in the rehabilitation groups postintervention. Academic performance and perceptual-motor integration were evaluated in children with SLD before and after rehabilitation using the Mathematics, Reading, and Writing Assessment Scale (MOYA) and the Bender-Gestalt Visual Motor Perception Test (BGT).
RESULTS: At baseline, children with SLD demonstrated significantly poorer balance performance on the Sensory Organization Test (SOT), Adaptation Test (AT), and Limits of Stability (LOS) compared with controls (p < .05), while VNG findings did not differ between groups (p > .05). Following rehabilitation, both intervention groups showed significant improvements in SOT, AT, and LOS parameters (p < .05). MOYA and BGT scores also improved significantly (p < .001). The VR-based rehabilitation group demonstrated greater improvement in vestibular-related balance scores and leftward saccadic velocity than the traditional group (p < .05).
CONCLUSIONS: Vestibular rehabilitation may improve balance and functional outcomes in children with SLDs. Both traditional and VR-based approaches appeared beneficial, with VR-based rehabilitation showing a tendency toward further improvements in selected vestibular and oculomotor measures. These findings suggest that vestibular rehabilitation, including VR-assisted methods, may represent a complementary intervention in this population, although further studies are needed to clarify long-term effects.