前庭分裂瘤切除术后患者转弯速度的恢复

Angela R. Weston, Leland Dibble, Peter Fino, Rich Lisonbee, Carrie Hoppes, Brian Loyd
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摘要

背景:前庭分裂瘤切除术(VSR)后的患者会出现明显的前庭症状,翻身时可引起这些症状。前庭康复有助于功能恢复和症状缓解,但转弯反应尚不清楚。目的:研究峰值转弯速度对手术和康复的反应。方法:8 名前庭分裂瘤患者(PwVS)和 5 名健康对照组(HC)参加了这项研究。在进行术前、术后和治疗后评估时,使用惯性测量单元(IMU)捕捉头部和/或躯干在完成转弯任务时的峰值转弯速度(PTS)。前庭康复治疗每周两次,为期六周。采用线性混合模型评估各时间点 PTS 的变化。结果:术前,PwVS 的 PTS 比 HC 慢。与术前相比,术后在头部转体行走(B = -61.03,p = 0.004)、两分钟步行测试(B = -37.33,p = 0.015)、360°转体(B 范围从 50.05 到 -57.4,p <0.05)和躯干复杂转体过程(CTC)(B = -18.63,p = 0.009)时的 PTS 明显较慢。在头部(B = 18.46,p = 0.014)和躯干(B = 15.99,p = 0.023)的 CTC 期间,治疗后的 PTS 明显快于手术前。结论:PwVS 在手术切除前可能存在翻身障碍。PTS 在术后受到明显影响,但在康复治疗后会有所改善。
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Recovery of turning speed in patients after vestibular schwannoma resection
BACKGROUND: Individuals after a vestibular schwannoma resection (VSR) experience significant vestibular symptoms that can be provoked with turning. Vestibular rehabilitation assists in recovery of function and symptom relief, however turning response is unknown. OBJECTIVE: Examine peak turning speed response to surgery and rehabilitation. METHODS: Eight participants with a vestibular schwannoma (PwVS) and five healthy controls (HC) participated in this study. Peak turning speed (PTS) was captured with inertial measurement units (IMU) at the head and/or trunk during turning tasks at a pre-operative, post-operative and post-treatment assessment. Vestibular rehabilitation was provided twice weekly for six weeks. Linear mixed models were used to assess change in PTS across time points. RESULTS: PwVS performed slower PTS than HC prior to surgery. PTS was significantly slower post-operatively compared to pre-operative during walking with head turns (B = –61.03, p = 0.004), two-minute walk test (B = –37.33, p = 0.015), 360° turn (B range from 50.05 to –57.4, p <  0.05) and complex turning course (CTC) at the trunk (B = –18.63, p = 0.009). Post-treatment PTS was significantly faster than pre-operative during CTC at the head (B = 18.46, p = 0.014) and trunk (B = 15.99, p = 0.023). CONCLUSION: PwVS may have turning deficits prior to surgical resection. PTS was significantly affected post-operatively, however improved with rehabilitation.
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