Cargando…

Effectiveness and acceptance of Vestibulo-Ocular Reflex adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction and normal balance function

OBJECTIVE: This was a block randomized controlled study to evaluate the effectiveness and acceptance of Vestibulo-Ocular Reflex (VOR) adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction (UVD) and normal balance function. METHODS: Thirty children, aged 4–13 y...

Descripción completa

Detalles Bibliográficos
Autores principales: Ma, Ning, Liu, Handi, Liu, Bing, Zhang, Li, Li, Bei, Yang, Yang, Liu, Wei, Chen, Min, Shao, Jianbo, Zhang, Xiao, Ni, Xin, Zhang, Jie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9800911/
https://www.ncbi.nlm.nih.gov/pubmed/36588896
http://dx.doi.org/10.3389/fneur.2022.996715
_version_ 1784861387727568896
author Ma, Ning
Liu, Handi
Liu, Bing
Zhang, Li
Li, Bei
Yang, Yang
Liu, Wei
Chen, Min
Shao, Jianbo
Zhang, Xiao
Ni, Xin
Zhang, Jie
author_facet Ma, Ning
Liu, Handi
Liu, Bing
Zhang, Li
Li, Bei
Yang, Yang
Liu, Wei
Chen, Min
Shao, Jianbo
Zhang, Xiao
Ni, Xin
Zhang, Jie
author_sort Ma, Ning
collection PubMed
description OBJECTIVE: This was a block randomized controlled study to evaluate the effectiveness and acceptance of Vestibulo-Ocular Reflex (VOR) adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction (UVD) and normal balance function. METHODS: Thirty children, aged 4–13 years, diagnosed with recurrent vertigo of childhood (RVC) with UVD (according to a caloric test) and normal balance function were analyzed. These 30 children were divided into 10 blocks based on similar age and severity of vertigo. Three children in each block were randomly assigned to one of three groups to receive 1 month of treatment. Group A received vestibular-ocular reflex (VOR) adaptation training, Group B received Cawthorne-Cooksey training, and a control group received no training. All children were administered pharmacotherapy [Ginkgo biloba leaf extract (drops)]. The Dizziness Handicap Inventory (DHI), Visual Analog Scale of Quality of Life with Vertigo (VAS-QLV), and canal paralysis (CP) on the caloric test were recorded before and after treatment, and the effectiveness of treatment was evaluated. The Visual Analog Scale of Acceptance (VAS-A) was used to evaluate the acceptance of the training in the two groups that received training. RESULTS: There were 10 children each in Group A, Group B, and the control group; the male to female ratio was 1, and the average age in each group was 9.0 ± 3.2, 8.4 ± 3.0, and 8.3 ± 2.6 years, respectively. The effective rate was 100% in Group A, 65% in Group B, and 60% in Group C. The recovery rate on caloric testing after treatment was 100, 70, and 50%, respectively. DHI scores before and after training were 56.8 ± 12.4 and 8.8 ± 6.1 in Group A, 57.8 ± 12.6 and 18.8 ± 9.7 in Group B, and 56.8 ± 12.4 and 24.0 ± 15.3 in Group C (all P = 0.000). VAS-QLV scores before and after training were 7.5 ± 1.0 and 0.9 ± 0.9 in Group A, 6.4 ± 2.2 and 2.7 ± 1.1 in Group B, and 6.6 ± 1.6 and 2.6 ± 1.4 in Group C (all P < 0.05). The CP values before and after training were 35.7 ± 15.1 and 12.9 ± 8.7 in Group A, 33.6 ± 20.1 and 23.6 ± 19.3 in Group B, and 38.6 ± 21.1 and 24.8 ± 17.9 in Group C (P = 0.001, P = 0.015, and P = 0.050, respectively). Between-group comparisons showed that the decreases in DHI and VAS-QLV scores after training were significantly different (P = 0.015, P = 0.02), while CP values were not (P = 0.139). After training, the DHI value had decreased significantly more in Group A compared with Group C (P < 0.05), but there were no other differences. After training, VAS-QLV scores in Group A had decreased significantly more compared with Group B and C (P < 0.05). In terms of acceptance, the VAS-A score was 7.6 ± 2.2 in Group A and 3.1 ± 2.8 in Group B (P =0.004), The acceptance rate was 70% in group A and 10% in group B. there was no significant correlation between age and VAS-A in either group A or group B (P > 0.05). CONCLUSION: This study strongly suggests that vestibular rehabilitation training should be performed in children with vertigo to improve symptoms. For children with RVC with UVD but normal balance function, a single VOR adaptation program can effectively improve vertigo symptoms, and given its simplicity, time-effectiveness, and excellent outcomes, it is associated with better acceptance in children compared to classic Cawthorne-Cooksey training.
format Online
Article
Text
id pubmed-9800911
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-98009112022-12-31 Effectiveness and acceptance of Vestibulo-Ocular Reflex adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction and normal balance function Ma, Ning Liu, Handi Liu, Bing Zhang, Li Li, Bei Yang, Yang Liu, Wei Chen, Min Shao, Jianbo Zhang, Xiao Ni, Xin Zhang, Jie Front Neurol Neurology OBJECTIVE: This was a block randomized controlled study to evaluate the effectiveness and acceptance of Vestibulo-Ocular Reflex (VOR) adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction (UVD) and normal balance function. METHODS: Thirty children, aged 4–13 years, diagnosed with recurrent vertigo of childhood (RVC) with UVD (according to a caloric test) and normal balance function were analyzed. These 30 children were divided into 10 blocks based on similar age and severity of vertigo. Three children in each block were randomly assigned to one of three groups to receive 1 month of treatment. Group A received vestibular-ocular reflex (VOR) adaptation training, Group B received Cawthorne-Cooksey training, and a control group received no training. All children were administered pharmacotherapy [Ginkgo biloba leaf extract (drops)]. The Dizziness Handicap Inventory (DHI), Visual Analog Scale of Quality of Life with Vertigo (VAS-QLV), and canal paralysis (CP) on the caloric test were recorded before and after treatment, and the effectiveness of treatment was evaluated. The Visual Analog Scale of Acceptance (VAS-A) was used to evaluate the acceptance of the training in the two groups that received training. RESULTS: There were 10 children each in Group A, Group B, and the control group; the male to female ratio was 1, and the average age in each group was 9.0 ± 3.2, 8.4 ± 3.0, and 8.3 ± 2.6 years, respectively. The effective rate was 100% in Group A, 65% in Group B, and 60% in Group C. The recovery rate on caloric testing after treatment was 100, 70, and 50%, respectively. DHI scores before and after training were 56.8 ± 12.4 and 8.8 ± 6.1 in Group A, 57.8 ± 12.6 and 18.8 ± 9.7 in Group B, and 56.8 ± 12.4 and 24.0 ± 15.3 in Group C (all P = 0.000). VAS-QLV scores before and after training were 7.5 ± 1.0 and 0.9 ± 0.9 in Group A, 6.4 ± 2.2 and 2.7 ± 1.1 in Group B, and 6.6 ± 1.6 and 2.6 ± 1.4 in Group C (all P < 0.05). The CP values before and after training were 35.7 ± 15.1 and 12.9 ± 8.7 in Group A, 33.6 ± 20.1 and 23.6 ± 19.3 in Group B, and 38.6 ± 21.1 and 24.8 ± 17.9 in Group C (P = 0.001, P = 0.015, and P = 0.050, respectively). Between-group comparisons showed that the decreases in DHI and VAS-QLV scores after training were significantly different (P = 0.015, P = 0.02), while CP values were not (P = 0.139). After training, the DHI value had decreased significantly more in Group A compared with Group C (P < 0.05), but there were no other differences. After training, VAS-QLV scores in Group A had decreased significantly more compared with Group B and C (P < 0.05). In terms of acceptance, the VAS-A score was 7.6 ± 2.2 in Group A and 3.1 ± 2.8 in Group B (P =0.004), The acceptance rate was 70% in group A and 10% in group B. there was no significant correlation between age and VAS-A in either group A or group B (P > 0.05). CONCLUSION: This study strongly suggests that vestibular rehabilitation training should be performed in children with vertigo to improve symptoms. For children with RVC with UVD but normal balance function, a single VOR adaptation program can effectively improve vertigo symptoms, and given its simplicity, time-effectiveness, and excellent outcomes, it is associated with better acceptance in children compared to classic Cawthorne-Cooksey training. Frontiers Media S.A. 2022-12-16 /pmc/articles/PMC9800911/ /pubmed/36588896 http://dx.doi.org/10.3389/fneur.2022.996715 Text en Copyright © 2022 Ma, Liu, Liu, Zhang, Li, Yang, Liu, Chen, Shao, Zhang, Ni and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Ma, Ning
Liu, Handi
Liu, Bing
Zhang, Li
Li, Bei
Yang, Yang
Liu, Wei
Chen, Min
Shao, Jianbo
Zhang, Xiao
Ni, Xin
Zhang, Jie
Effectiveness and acceptance of Vestibulo-Ocular Reflex adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction and normal balance function
title Effectiveness and acceptance of Vestibulo-Ocular Reflex adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction and normal balance function
title_full Effectiveness and acceptance of Vestibulo-Ocular Reflex adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction and normal balance function
title_fullStr Effectiveness and acceptance of Vestibulo-Ocular Reflex adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction and normal balance function
title_full_unstemmed Effectiveness and acceptance of Vestibulo-Ocular Reflex adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction and normal balance function
title_short Effectiveness and acceptance of Vestibulo-Ocular Reflex adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction and normal balance function
title_sort effectiveness and acceptance of vestibulo-ocular reflex adaptation training in children with recurrent vertigo with unilateral vestibular dysfunction and normal balance function
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9800911/
https://www.ncbi.nlm.nih.gov/pubmed/36588896
http://dx.doi.org/10.3389/fneur.2022.996715
work_keys_str_mv AT maning effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT liuhandi effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT liubing effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT zhangli effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT libei effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT yangyang effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT liuwei effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT chenmin effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT shaojianbo effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT zhangxiao effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT nixin effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction
AT zhangjie effectivenessandacceptanceofvestibuloocularreflexadaptationtraininginchildrenwithrecurrentvertigowithunilateralvestibulardysfunctionandnormalbalancefunction