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首页> 外文期刊>BMC Neurology >Assessment and rehabilitation of central sensory impairments for balance in mTBI using auditory biofeedback: a randomized clinical trial
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Assessment and rehabilitation of central sensory impairments for balance in mTBI using auditory biofeedback: a randomized clinical trial

机译：使用听觉生物反馈评估和改善mTBI中枢感觉障碍的中央感觉障碍：一项随机临床试验

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Background Complaints of imbalance are common non-resolving signs in individuals with post-concussive syndrome. Yet, there is no consensus rehabilitation for non-resolving balance complaints following mild traumatic brain injury (mTBI). The heterogeneity of balance deficits and varied rates of recovery suggest varied etiologies and a need for interventions that address the underlying causes of poor balance function. Our central hypothesis is that most chronic balance deficits after mTBI result from impairments in central sensorimotor integration that may be helped by rehabilitation. Two studies are described to 1) characterize balance deficits in people with mTBI who have chronic, non-resolving balance deficits compared to healthy control subjects, and 2) determine the efficacy of an augmented vestibular rehabilitation program using auditory biofeedback to improve central sensorimotor integration, static and dynamic balance, and functional activity in patients with chronic mTBI. Methods Two studies are described. Study 1 is a cross-sectional study to take place jointly at Oregon Health and Science University and the VA Portland Health Care System. The study participants will be individuals with non-resolving complaints of balance following mTBI and age- and gender-matched controls who meet all inclusion criteria. The primary outcome will be measures of central sensorimotor integration derived from a novel central sensorimotor integration test. Study 2 is a randomized controlled intervention to take place at Oregon Health & Science University. In this study, participants from Study 1 with mTBI and abnormal central sensorimotor integration will be randomized into two rehabilitation interventions. The interventions will be 6?weeks of vestibular rehabilitation 1) with or 2) without the use of an auditory biofeedback device. The primary outcome measure is the daily activity of the participants measured using an inertial sensor. Discussion The results of these two studies will improve our understanding of the nature of balance deficits in people with mTBI by providing quantitative metrics of central sensorimotor integration, balance, and vestibular and ocular motor function. Study 2 will examine the potential for augmented rehabilitation interventions to improve central sensorimotor integration. Trial registration This trial is registered at clinicaltrials.gov ( NCT02748109 )
机译：背景不平衡的投诉是脑震荡后综合症患者常见的无法解决的体征。然而，对于轻度脑外伤（mTBI）后无法解决的平衡问题，尚无共识的康复方法。平衡赤字的异质性和不同的恢复率表明病因不同，需要采取干预措施解决平衡功能差的根本原因。我们的中心假设是，mTBI之后的大多数慢性平衡不足是由中枢感觉运动整合障碍引起的，康复可能会帮助这种情况。描述了两项研究，以1）表征与健康对照组相比患有慢性非解决性平衡缺陷的mTBI患者的平衡缺陷，以及2）使用听觉生物反馈改善前庭康复计划以改善中枢感觉运动整合的功效，慢性mTBI患者的静态和动态平衡以及功能活动。方法描述了两项研究。研究1是一项横断面研究，将在俄勒冈健康科学大学和VA波特兰医疗保健系统共同进行。研究参与者将是在满足所有纳入标准后，由于mTBI以及年龄和性别匹配的对照而无法解决平衡问题的个人。主要结果将是源自新的中央感觉运动整合测试的中央感觉运动整合测量。研究2是在俄勒冈健康与科学大学进行的随机对照干预。在这项研究中，来自研究1的mTBI和中枢感觉运动异常的参与者将被随机分为两种康复干预措施。干预将是前庭康复的6周，即1）有或2）不使用听觉生物反馈装置。主要结果指标是使用惯性传感器测得的参与者的日常活动。讨论这两项研究的结果将通过提供中央感觉运动整合，平衡以及前庭和眼部运动功能的定量指标，来增进我们对mTBI患者平衡缺陷性质的理解。研究2将研究增强康复干预措施以改善中枢感觉运动整合的潜力。试验注册该试验已在Clinicaltrials.gov（NCT02748109）上进行了注册。

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