Efficacy Study Of Vestibular Rehabilitation Training For Vertigo And Balance Disorder

【Background】Vertigo(Vertigo)is one of the most common symptoms in the department of neurology,refers to the orientation or balance of the spatial relationship,is an illusion of itself or the outside world.It can be divided into peripheral vertigo and central vertigo according to the lesion site.For the former,the most common clinical causes are benign paroxysmal positional vertigo(BPPV),vestibular matrix disease(VP),vestibular neuritis(VN),Meniere disease(MD)and so on.Among them,most BPPV patients disappeared after otolith reduction,typical positional nystagmus and vertigo,but some patients still have head dizziness,head discomfort,head-heavy,walking instability and neck stiffness after successful reduction,and balance disorder is the most common dysfunction.Central vertigo is mostly seen in posterior circulation stroke,intracranial space-occupying lesions,etc.Vertigo and balance disorder are the most prominent and common symptoms of these diseases,and often persist in the recovery period of the disease.Patients with central vertigo after the circulating blood supply area involvement,common brainstem and cerebellar infarction or bleeding,posterior circulation disorders,occasionally seen in multiple sclerosis,posterior fossa tumor,etc.Clinically,it can show dizziness,gait and balance dysfunction,limb movement disorders,etc.It can be seen that balance dysfunction is a common dysfunction.Its main mechanisms,in addition to vestibular dysfunction,also include proprioceptive disorder,visual system disorder,decreased central nervous system integration ability,decreased muscle strength of core muscle group,and weakened muscle synergy.In order to reduce the risk of falls and improve patient balance control,on the basis of routine drugs and limb rehabilitation training,this study through the individualized vestibular rehabilitation training,aims to explore the vestibular rehabilitation in central vertigo patients balance control and daily life ability,provide reference for clinical rehabilitation treatment.【Objective】This study aims to explore the vestibular rehabilitation training of residual symptoms after reduction of BPPV and ischemic stroke with balance dysfunction and vertigo symptoms after personalized vestibular rehabilitation treatment for the physical function /structure and level of individual activity / social participation evaluation,to provide more basis for clinical diagnosis,treatment and individualized rehabilitation treatment.Furthermore,it provides the beneficial experience of rehabilitation treatment for other patients with vestibular system diseases.【Subjects and method】According to the principle of targeted rehabilitation training,119 patients were divided into two groups: residual vertigo,balance disorder and ischemic stroke with vertigo and balance disorder after BPPV reduction treatment.After BPPV reduction treatment,a total of 72 people in the group with residual symptoms,randomly divided into(1)group(experimental group)and(2)group(control group),each group of 36 cases,(1)group was given drug combined with vestibular rehabilitation treatment as the experimental group,(2)group as the control group gave pure drug treatment.After circulatory infarction with vertigo,balance disorder,a total of 37 people,randomly divided into(3)group(experimental group)19,(4)group(control group)18 people,(3)group given drug combined vestibular rehabilitation treatment as experimental group,(4)group as control group as study group,comparative analysis of each group,1 week after treatment,4 weeks after treatment,DHI score,Berg score.Differences in vertigo symptoms and balance function before and after treatment between the(1)(2)and(3)(4)groups,respectively.【Results】In the fourth week of the study,the DHI score and BBS decreased according to the(1)(2)(3)(4)group.The evaluation of vertigo and disability measurement(DHI)were significantly improved than before treatment(P <0.01);either BPPV with residual symptoms or B ischemic stroke(P <0.01).Comparative analysis of the changes in DHI scores and BBS score at 1 and 4 weeks after treatment found P <0.01 at 4 weeks after treatment compared with before treatment.【Conclusions】1.The vestibular rehabilitation training combined with pharmacotherapy and pharmacotherapy alone were effective in the treatment of residual symptoms after BPPV reduction.Festibular rehabilitation training combined with drug therapy performed better on residual symptoms after BPPV reduction than on medication alone.2.vestibular rehabilitation training combined with drug therapy and drug therapy alone is effective in the treatment of vertigo and balance disorder in ischemic stroke.The vestibular rehabilitation training combined with drug therapy works better on vertigo and balance disorders in ischemic stroke than on medication alone.3.The improvement of vestibular rehabilitation training combined with medication resulted in both physical function / structure and individual activity / social participation levels in BPPV patients with residual symptoms.4.Vestibular rehabilitation can establish vestibular compensation,which is beneficial for the recovery of vertigo and balance disorders caused by central vestibular lesions in patients with ischemic stroke.