受累半规管与良性阵发性位置性眩晕的功能限制和焦虑之间的关系

文献信息

中文摘要

背景： 良性阵发性位置性眩晕（BPPV）会导致日常生活活动中的功能受限，增加跌倒风险，并导致焦虑增加。
目的： 评估BPPV患者受累半规管的平面与功能限制、跌倒风险和焦虑之间的关系。
研究设计： 对接受耳石复位手法治疗的单半规管受累BPPV患者施测前庭疾病日常生活活动量表（VADL）、Berg平衡量表（BBS）和汉密尔顿焦虑评定量表（HAM-A）。多半规管受累的患者未纳入研究。比较后半规管、水平半规管和前半规管BPPV组之间的评分。
研究样本： 纳入2021年5月至10月期间以眩晕就诊并被诊断为BPPV的18-65岁成人。
数据收集与分析： 使用Kruskal-Wallis检验评估半规管亚型之间的组间差异。进一步采用经年龄和性别调整的单因素协方差分析检验半规管组之间的组间比较。事后两两比较采用Bonferroni校正。对于分类变量，采用Pearson χ2检验评估组间差异。
结果： 前半规管BPPV患者的VADL评分显著较低，而HAM-A和BBS评分未因半规管受累而不同。女性表现出更高的焦虑和跌倒风险评分，年龄最大组的BBS评分较低。
结论： 根据VADL评分，前半规管BPPV与后半规管或水平半规管BPPV相比功能限制较少。焦虑和跌倒风险评分未显示与半规管相关的差异。
临床相关性声明： 临床医生可以利用半规管平面来设定日常功能恢复的预期，同时无论半规管如何都应优先考虑跌倒预防策略。

英文摘要

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) causes functional limitations in activities of daily living, increases the risk of falls, and leads to increased anxiety.
PURPOSE: To assess the relationship between the plane of the affected semicircular canal and functional limitations, fall risk, and anxiety in patients with BPPV.
RESEARCH DESIGN: The Vestibular Disorders Activities of Daily Living Scale (VADL), the Berg Balance Scale (BBS), and the Hamilton Anxiety Rating Scale (HAM-A) were administered to patients with BPPV with single-canal involvement who were treated with canalith repositioning maneuvers. Patients with multicanal involvement were not included in the study. Scores were compared among posterior, lateral, and anterior canal BPPV groups.
STUDY SAMPLE: Adults aged 18-65 years presenting with vertigo and diagnosed with BPPV between May and October 2021 were included.
DATA COLLECTION AND ANALYSIS: Group differences among canal subtypes were evaluated using the Kruskal-Wallis test. Between-group comparisons among canal groups were further examined with a one-way analysis of covariance adjusted for age and sex. Bonferroni correction was applied for post hoc pairwise comparisons. For categorical variables, between-group differences were assessed with Pearson's χ2 test.
RESULTS: Patients with anterior canal BPPV had significantly lower VADL scores, whereas HAM-A and BBS scores did not differ by canal involvement. Women showed higher anxiety and fall risk scores, and the oldest age group had lower BBS scores.
CONCLUSIONS: According to VADL scores, anterior canal BPPV was associated with less functional limitation than posterior or lateral canal BPPV. Anxiety and fall risk scores showed no canal-related differences.
CLINICAL RELEVANCE STATEMENT: Clinicians can use the canal plane to set expectations for daily function recovery while prioritizing fall prevention strategies irrespective of canal.