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Вестибулярная реабилитация: обоснование, показания, применение
Пальчун В.Т., Гусева А.Л., Чистов С.Д. Вестибулярная реабилитация: обоснование, показания, применение. Consilium Medicum. 2015; 17 (9): 113–120. DOI: 10.26442/2075-1753_2015.9.113-120
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Palchun V.T., Guseva A.L., Chistov S.D. Vestibular rehabilitation: substantiation, indications, application. Consilium Medicum. 2015; 17 (9): 113–120. DOI: 10.26442/2075-1753_2015.9.113-120
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Аннотация
Вестибулярная реабилитация является эффективным и недорогостоящим методом терапии пациентов с головокружением и нарушением равновесия. В статье рассмотрены особенности вестибулярной реабилитации при доброкачественном пароксизмальном позиционном головокружении, периферической односторонней и двусторонней вестибулопатии, а также центральной вестибулопатии. Представлены механизмы вестибулярной компенсации, упражнения, репозиционные маневры, принципы составления индивидуальной программы, особенности медикаментозной терапии.
Ключевые слова: вестибулярная реабилитация, доброкачественное пароксизмальное позиционное головокружение, вестибулярная адаптация, вестибулярное замещение, головокружение.
Ключевые слова: вестибулярная реабилитация, доброкачественное пароксизмальное позиционное головокружение, вестибулярная адаптация, вестибулярное замещение, головокружение.
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Vestibular rehabilitation therapy is effective and inexpensive management of patients with dizziness and balance disorders. Here the authors discuss vestibular rehabilitation for patients with benign paroxysmal positional vertigo, unilateral vestibular loss or hypofunction, bilateral vestibular loss/hypofunction and central vestibular disorders. They describe different mechanisms of vestibular compensation, exercises that are used, repositioning maneuvers, principles of conducting a vestibular rehabilitation program and drug therapy.
Key words: vestibular rehabilitation, benign paroxysmal positional vertigo, vestibular adaptation, vestibular substitution, dizziness, vertigo.
Key words: vestibular rehabilitation, benign paroxysmal positional vertigo, vestibular adaptation, vestibular substitution, dizziness, vertigo.
Полный текст
Список литературы
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25. Porciuncula F, Johnson CC, Glickman LB. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review. J Vestib Res 2012; 22: 283–98. Doi: 10.3233/VES-120464.
26. Herdman SJ, Blatt P, Schubert MC, Tusa RJ. Falls in patients with vestibular deficits. Am J Otol 2000; 21: 847–51.
27. Van de Berg R, Guinand N, Nguyen TA et al. The vestibular implant: frequency-dependency of the electrically evoked vestibulo-ocular reflex in humans. Front Syst Neurosci 2015; 8: 255. Doi: 10.3389/fnsys.2014.00255.
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29. Naguib MB, Madian YT. Betahistine dihydrochloride with and without early vestibular rehabilitation for the management of patients with balance disorders following head trauma: a preliminary randomized clinical trial. J Chiropr Med 2014; 13 (1): 14–20. Doi: 10.1016/j.jcm.2014.01.011.
30. Karapolat H, Celebisoy N, Kirazli Y et al. Does betahistine treatment have additional benefits to vestibular rehabilitation? Eur Arch Otorhinolaryngol 2010; 267 (8): 1207–12. Doi: 10.1007/s00405-010-1216-0.
31. Brown KE, Whitney SL, Marchetti GF et al. Physical therapy for central vestibular dysfunction. Arch Phys Med Rehabil 2006; 87: 76–81.
32. Furman JM, Marcus DA. Migraine and motion sensitivity. Continuum (Minneap Minn) 2012; 18: 1102–17. Doi: 10.1212/01.CON.0000421621.18407.96.
33. Norré ME, De Weerdt W. Treatment of vertigo based on habituation. 2. Technique and results of habituation training. J Laryngol Otol 1980; 94 (9): 971–7.
34. Shepard NT, Telian SA. Programmatic vestibular rehabilitation. Otolaryngol Head Neck Surg 1995; 112 (1): 173–82.
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38. Bles W, Vianney de Jong JM, De Wit G. Compensation for labyrinthine defects examined by use of a tilting room. Acta Otolaryngol 1983; 95: 576–9.
39. Pavlou M, Shumway-Cook A, Horak FB et al. Rehabilitation of balance disorders in the patient with vestibular pathology. In: A.M.Bronstein, T.Brandt, M.H.Woollacott, J.G.Nutt. Clinical Disorders of Balance, Posture and Gait. 2nd ed. London: Arnold, 2004; p. 317–43.
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41. Pavlou M, Davies RA, Bronstein AM. The assessment of increased sensitivity to visual stimuli in patients with chronic dizziness. J Vestib Res 2006; 16: 223–31.
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45. Erren-Wolters CV, Van Dijk H, De Kort AC et al. Virtual reality for mobility devices: training applicationsand clinical results: a review. Int J Rehabil Res 2007; 30: 91–6.
46. Sparrer I, Duong Dinh TA, Ilgner J, Westhofen M. Vestibular rehabilitation using the NintendoR Wii Balance Board – a user friendly alternative for central nervous compensation. Acta Otolaryngol 2013; 133: 239–45.
47. Danilov YP, Tyler ME, Skinner KL et al. Efficacy of electrotactile vestibular substitution in patients with peripheral and central vestibular loss. J Vestib Res 2007; 17 (2–3): 119–30.
48. Janssen M, Pas R, Aarts J et al. Clinical observational gait analysis to evaluate improvement of balance during gait with vibrotactile biofeedback. Physiother Res Int 2012; 17 (1): 4–11. Doi: 10.1002/pri.504.
49. Tsang WW, Hui-Chan CW. Standing balance after vestibular stimulation in Tai Chi-practicing and nonpracticing healthy older adults. Arch Phys Med Rehabil 2006; 87: 546–53.
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2. Agrawal Y, Carey JP, Della Santina C et al. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001–2004. Arch Intern Med 2009; 169 (10): 938–44. Doi: 10.1001/archinternmed.2009.66.
3. Neuhauser HK, Von Brevern M, Radtke A et al. Epidemiology of vestibular vertigo: a neurotologic survey of the general population. Neurology 2005; 65 (6): 898–904. Doi: 10.1212/01.wnl.0000175987.59991.3d.
4. Young LR, Bernard-Demanze L, Dumitrescu M et al. Postural performance of vestibular loss patients under increased postural threat. J Vestib Res 2012; 22 (2): 129–38. Doi: 10.3233/VES-2012-0449.
5. Лучихин Л.А., Гусева А.Л., Бауш Я.А. Соматосенсорные расстройства. Изменение качества жизни при периферической вестибулярной дисфункции. Вестн. оториноларингологии. 2011; 2: 72–5. / Luchikhin L.A., Guseva A.L., Baush Ia.A. Somatosensornye rasstroistva. Izmenenie kachestva zhizni pri perifericheskoi vestibuliarnoi disfunktsii. Vestn. otorinolaringologii. 2011; 2: 72–5. [in Russian]
6. Cawthorne T, Cooksey FS. Original Cawthorne–Cooksey rehabilitation exercises. Proc Roy Soc Med 1946; 39: 270–3.
7. McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev 2015; 1: CD005397. Doi: 10.1002/14651858.CD005397.pub4.
8. Пальчун В.Т., Кунельская Н.Л., Ротермель Е.В. Диагностика и лечение доброкачественного пароксизмального позиционного головокружения. Вестн. оториноларингологии. 2007; 1: 4–7. / Pal'chun V.T., Kunel'skaia N.L., Rotermel' E.V. Diagnostika i lechenie dobrokachestvennogo paroksizmal'nogo pozitsionnogo golovokruzheniia. Vestn. otorinolaringologii. 2007; 1: 4–7. [in Russian]
9. Bhattacharyya N, Baugh RF, Orvidas L et al. American Academy of Otolaryngology-Head and Neck Surgery Foundation. Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2008; 139 (5 Suppl. 4): S47–81. Doi: 10.1016/j.otohns.2008.08.022.
10. Fife TD, Iverson DJ, Lempert T et al. Quality Standards Subcommittee, American Academy of Neurology. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2008; 70 (22): 2067–74. Doi: 10.1212/01.wnl.0000313378.77444.ac.
11. Guneri EA, Kustutan O. The effects of betahistine in addition to epley maneuver in posterior canal benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2012; 146 (1): 104–8. Doi: 10.1177/0194599811419093.
12. Dispenza F, Kulamarva G, De Stefano A. Comparison of repositioning maneuvers for benign paroxysmal positional vertigo of posterior semicircular canal: advantages of hybrid maneuver. Am J Otolaryngol 2012; 33 (5): 528–32. Doi: 10.1016/j.amjoto.2011.12.002.
13. Epley JM. Canalith repositioning maneuver. Otolaryngol Head Neck Surg 1994; 111 (5): 688–90. Doi:10.1016/s0194-5998(94)70547-x.
14. Semont A, Freyss G, Vitte E. Curing the BPPV with a liberatory maneuver. Adv Otorhinolaryngol 1988; 42: 290–3. Doi:10.1159/000416126.
15. Soto-Varela A, Rossi-Izquierdo M, Santos-Pérez S. Can we predict the efficacy of the semont maneuver in the treatment of benign paroxysmal positional vertigo of the posterior semicircular canal? Otol Neurotol 2011; 32 (6): 1008–11. Doi: 10.1097/MAO.0b013e3182267f02.
16. Brandt T, Daroff RB. Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol 1980; 106 (8): 484–5.
17. Lempert T, Tiel-Wilck K. A positional maneuver for treatment of horizontal-canal benign positional vertigo. Laryngoscope 1996; 106 (4): 476–8.
18. Gufoni M, Mastrosimone L, Di Nasso F. Repositioning maneuver in benign paroxysmal vertigo of horizontal semicircular canal. Acta Otorhinolaryngo Ital 1998; 18 (6): 363–7.
19. Vannucchi P, Giannoni B, Pagnini P. Treatment of horizontal semicircular canal benign paroxysmal positional vertigo. J Vestib Res 1997; 7 (l): l–6.
20. Kim YK, Shin JE, Chung JW. The effect of canalith repositioning for anterior semicircular canal canalithiasis. ORL J Otorhinolaryngol Relat Spec 2005; 67 (1): 56–60. Doi:10.1159/000084336.
21. Yacovino DA, Hain TC, Gualtieri F. New therapeutic maneuver for anterior canal benign paroxysmal positional vertigo. J Neurol 2009; 256 (11): 1851–5. Doi: 10.1007/s00415-009-5208-1.
22. Herdman SJ. Exercise strategies for vestibular disorders. Ear Nose Throat J 1989; 68 (12): 961–4.
23. Shepard NT, Telian SA, Smith-Wheelock M, Raj A. Vestibular and balance rehabilitation therapy. Ann Otol Rhinol Laryngol 1993; 102: 198–205.
24. Garcia AP, Ganança MM, Cusin FS et al. Vestibular rehabilitation with virtual reality in Meniere’s disease. Braz J Otorhinolaryngol 2013; 79 (3): 366–74. Doi: 10.5935/1808-8694.20130064.
25. Porciuncula F, Johnson CC, Glickman LB. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review. J Vestib Res 2012; 22: 283–98. Doi: 10.3233/VES-120464.
26. Herdman SJ, Blatt P, Schubert MC, Tusa RJ. Falls in patients with vestibular deficits. Am J Otol 2000; 21: 847–51.
27. Van de Berg R, Guinand N, Nguyen TA et al. The vestibular implant: frequency-dependency of the electrically evoked vestibulo-ocular reflex in humans. Front Syst Neurosci 2015; 8: 255. Doi: 10.3389/fnsys.2014.00255.
28. Замерград М.В. Реабилитация при заболеваниях нервной системы. Неврология, нейропсихиатрия, психосоматика. 2013; 1: 18–22. / Zamergrad M.V. Reabilitatsiia pri zabolevaniiakh nervnoi sistemy. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2013; 1: 18–22. [in Russian]
29. Naguib MB, Madian YT. Betahistine dihydrochloride with and without early vestibular rehabilitation for the management of patients with balance disorders following head trauma: a preliminary randomized clinical trial. J Chiropr Med 2014; 13 (1): 14–20. Doi: 10.1016/j.jcm.2014.01.011.
30. Karapolat H, Celebisoy N, Kirazli Y et al. Does betahistine treatment have additional benefits to vestibular rehabilitation? Eur Arch Otorhinolaryngol 2010; 267 (8): 1207–12. Doi: 10.1007/s00405-010-1216-0.
31. Brown KE, Whitney SL, Marchetti GF et al. Physical therapy for central vestibular dysfunction. Arch Phys Med Rehabil 2006; 87: 76–81.
32. Furman JM, Marcus DA. Migraine and motion sensitivity. Continuum (Minneap Minn) 2012; 18: 1102–17. Doi: 10.1212/01.CON.0000421621.18407.96.
33. Norré ME, De Weerdt W. Treatment of vertigo based on habituation. 2. Technique and results of habituation training. J Laryngol Otol 1980; 94 (9): 971–7.
34. Shepard NT, Telian SA. Programmatic vestibular rehabilitation. Otolaryngol Head Neck Surg 1995; 112 (1): 173–82.
35. Pfaltz CR. Vestibular compensation. Physiological and clinical aspects. Acta Otolaryngol 1983; 95 (5–6): 402–6.
36. Schubert MC, Hall CD, Das V et al. Oculomotor strategies and their effect on reducing gaze position error. Otol Neurotol 2010; 31 (2): 228–31.
37. Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction of balance. Suggestion from the field. Phys Ther 1986; 66: 1548–50.
38. Bles W, Vianney de Jong JM, De Wit G. Compensation for labyrinthine defects examined by use of a tilting room. Acta Otolaryngol 1983; 95: 576–9.
39. Pavlou M, Shumway-Cook A, Horak FB et al. Rehabilitation of balance disorders in the patient with vestibular pathology. In: A.M.Bronstein, T.Brandt, M.H.Woollacott, J.G.Nutt. Clinical Disorders of Balance, Posture and Gait. 2nd ed. London: Arnold, 2004; p. 317–43.
40. Nyabenda A, Briart C, Deggouj N, Gersdorff M. Benefit of rotational exercises for patients with Meniere’s syndrome, method used by the ENT department of St-Luc university clinic. Ann Readapt Med Phys 2003; 46: 607–14.
41. Pavlou M, Davies RA, Bronstein AM. The assessment of increased sensitivity to visual stimuli in patients with chronic dizziness. J Vestib Res 2006; 16: 223–31.
42. Asai T, Misu S, Doi T et al. Effects of dual-tasking on control of trunk movement during gait: Respective effect of manual- and cognitive-task. Gait Posture 2014; 39 (1): 54–9. Doi: 10.1016/j.gaitpost.2013.05.025.
43. Bernard-Demanze L, Dumitrescu M, Jimeno P et al. Age-related changes in posture control are differentially affected by postural and cognitive task complexity. Curr Aging Sci 2009; 2: 139–49.
44. Кубряк О.В., Гроховский С.С., Исакова Е.В., Котов С.В. Биологическая обратная связь по опорной реакции: методология и терапевтические аспекты. М.: Маска, 2015. / Kubriak O.V., Grokhovskii S.S., Isakova E.V., Kotov S.V. Biologicheskaia obratnaia sviaz' po opornoi reaktsii: metodologiia i terapevticheskie aspekty. M.: Maska, 2015. [in Russian]
45. Erren-Wolters CV, Van Dijk H, De Kort AC et al. Virtual reality for mobility devices: training applicationsand clinical results: a review. Int J Rehabil Res 2007; 30: 91–6.
46. Sparrer I, Duong Dinh TA, Ilgner J, Westhofen M. Vestibular rehabilitation using the NintendoR Wii Balance Board – a user friendly alternative for central nervous compensation. Acta Otolaryngol 2013; 133: 239–45.
47. Danilov YP, Tyler ME, Skinner KL et al. Efficacy of electrotactile vestibular substitution in patients with peripheral and central vestibular loss. J Vestib Res 2007; 17 (2–3): 119–30.
48. Janssen M, Pas R, Aarts J et al. Clinical observational gait analysis to evaluate improvement of balance during gait with vibrotactile biofeedback. Physiother Res Int 2012; 17 (1): 4–11. Doi: 10.1002/pri.504.
49. Tsang WW, Hui-Chan CW. Standing balance after vestibular stimulation in Tai Chi-practicing and nonpracticing healthy older adults. Arch Phys Med Rehabil 2006; 87: 546–53.
50. Gabilan YP, Perracini MR, Munhoz MS, Gananc FF. Aquatic physiotherapy for vestibular rehabilitation in patients with unilateral vestibular hypofunction: exploratory prospective study. J Vestib Res 2008; 18: 139–46.
51. Schmid AA, Miller KK, Van Puymbroeck M, Schalk N. Feasibility and results of a case study of yoga to improve physical functioning in people with chronic traumatic brain injury. Disabil Rehabil 2015; 24: 1–7.
52. Dutheil S, Lacour M, Tighilet B. The neurogenetic potential of the vestibular nuclei and the recovery time course in the adult cat are governed by different mechanisms depending on the nature of the vestibular damage. PLoS One 2011; 6 (8): e22262. Doi: 10.1371/journal.pone.0022262.
53. Lacour M., Bernard-Demanze L. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery. Front Neurol 2015; 5: 285. Doi: 10.3389/fneur.2014.00285.
54. Whitney SL, Sparto PJ. Principles of vestibular physical therapy rehabilitation. Neurorehabilitation 2011; 29 (2): 157–66. Doi: 10.3233/NRE-2011-0690.
55. Пальчун В.Т., Кунельская Н.Л., Красюк А.А., Левина Ю.В. Особенности психосоматического статуса больных с кохлеовестибулярными нарушениями. Методы коррекции. Вестн. оториноларингологии. 2005; 6: 21–4. / Pal'chun V.T., Kunel'skaia N.L., Krasiuk A.A., Levina Iu.V. Osobennosti psikhosomaticheskogo statusa bol'nykh s kokhleovestibuliarnymi narusheniiami. Metody korrektsii. Vestn. otorinolaringologii. 2005; 6: 21–4. [in Russian]
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49. Tsang WW, Hui-Chan CW. Standing balance after vestibular stimulation in Tai Chi-practicing and nonpracticing healthy older adults. Arch Phys Med Rehabil 2006; 87: 546–53.
50. Gabilan YP, Perracini MR, Munhoz MS, Gananc FF. Aquatic physiotherapy for vestibular rehabilitation in patients with unilateral vestibular hypofunction: exploratory prospective study. J Vestib Res 2008; 18: 139–46.
51. Schmid AA, Miller KK, Van Puymbroeck M, Schalk N. Feasibility and results of a case study of yoga to improve physical functioning in people with chronic traumatic brain injury. Disabil Rehabil 2015; 24: 1–7.
52. Dutheil S, Lacour M, Tighilet B. The neurogenetic potential of the vestibular nuclei and the recovery time course in the adult cat are governed by different mechanisms depending on the nature of the vestibular damage. PLoS One 2011; 6 (8): e22262. Doi: 10.1371/journal.pone.0022262.
53. Lacour M., Bernard-Demanze L. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery. Front Neurol 2015; 5: 285. Doi: 10.3389/fneur.2014.00285.
54. Whitney SL, Sparto PJ. Principles of vestibular physical therapy rehabilitation. Neurorehabilitation 2011; 29 (2): 157–66. Doi: 10.3233/NRE-2011-0690.
55. Pal'chun V.T., Kunel'skaia N.L., Krasiuk A.A., Levina Iu.V. Osobennosti psikhosomaticheskogo statusa bol'nykh s kokhleovestibuliarnymi narusheniiami. Metody korrektsii. Vestn. otorinolaringologii. 2005; 6: 21–4. [in Russian]
56. Herdman SJ, Hall CD, Schubert MC et al. Recovery of dynamic visual acuity in bilateral vestibular hypofunction. Arch Otolaryngol Head Neck Surg 2007; 133: 383–9.
Авторы
В.Т.Пальчун*, А.Л.Гусева, С.Д.Чистов
ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*lorrsmu@mail.ru
ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*lorrsmu@mail.ru
________________________________________________
V.T.Palchun*, A.L.Guseva, S.D.Chistov
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*lorrsmu@mail.ru
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*lorrsmu@mail.ru
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