单侧/双侧前庭功能减退的前庭康复：一项系统综述。

文献信息

中文摘要

目的： 本系统综述的目的是探讨前庭康复（VR）能否改善被诊断为单侧或双侧前庭功能减退（VH）个体的平衡、症状和生活质量。
方法： 本系统综述所采用的方法学基于PRISMA 2020指南。方法学的第一步是进行全面的文献检索，以识别所有已发表的关于前庭康复与双侧VH的研究。该检索从六个不同的电子数据库（包括PubMed、Scopus、Web of Science、Cochrane Library、Embase和Science Direct）共找到509项研究；然而，要纳入本综述，必须是随机对照试验和前瞻性干预性研究。每项随机对照试验的偏倚风险均使用Cochrane偏倚风险2（RoB 2）工具进行评估。
结果： 在识别出的509条记录中，有八项研究共397名参与者符合纳入标准。研究人群包括单侧或双侧VH的男性和女性患者，处于急性期或慢性期。前庭康复始终与头晕严重程度、平衡表现、功能性移动能力和生活质量的显著改善相关，这些均通过经验证的结局指标进行评估，如头晕障碍量表、视觉模拟量表、计时起立-行走测试和Berg平衡量表。在干预组和对照组中均观察到改善；然而，在干预组中观察到更明显的改善，尤其是在使用基于虚拟现实、头戴式显示器辅助或游戏支持的前庭康复项目的研究中。由于研究设计、干预方案和结局指标的异质性，无法进行定量荟萃分析。
结论： 本系统综述表明，前庭康复对单侧和双侧VH患者均有益。在平衡、头晕严重程度和功能性结局指标方面，使用基于技术和/或虚拟现实的技术应比传统康复技术提供额外益处。

英文摘要

OBJECTIVE: The purpose of this systematic review was to investigate whether vestibular rehabilitation (VR) can improve balance, symptoms and quality of life in individuals diagnosed with unilateral or bilateral vestibular hypofunction (VH).
METHODS: The methodology used to conduct this systematic review was based on the PRISMA 2020 guidelines. The first step in the methodology was to conduct a thorough literature search to identify all published studies concerning vestibular rehabilitation and bilateral VH. This search resulted in a total of 509 studies found from six different electronic databases including; PubMed, Scopus, Web of Science, Cochrane Library, Embase and Science Direct; however, to be included in the review randomized controlled trials and prospective interventional studies. Each of the randomised controlled trial's risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool.
RESULTS: Of the 509 records identified, eight studies comprising 397 participants met the inclusion criteria. Study populations included both male and female patients with unilateral or bilateral VH, presenting in acute or chronic stages. VR was consistently associated with significant improvements in dizziness severity, balance performance, functional mobility, and quality of life, as assessed using validated outcome measures such as the Dizziness Handicap Inventory, Visual Analog Scale, Timed Up and Go, and Berg Balance Scale. Improvements were observed in both intervention and control groups; however, more pronounced improvements were observed in the intervention groups, particularly in studies utilizing virtual reality-based, head-mounted display-assisted, or gaming-supported vestibular rehabilitation programs. Due to heterogeneity in study design, intervention protocols, and outcome measures, quantitative meta-analysis was not feasible.
CONCLUSION: The systematic review suggests VR can be of benefit to patients with both unilateral and bilateral VH. Using technology based and/or virtual reality techniques should provide additive benefits over traditional rehabilitation techniques with respect to balance, dizziness severity, and functional outcome measures.