UNASSIGNED: This was a multi-centre, three-arm, parallel-groups, randomised, feasibility trial. Recruitment was via convenience sampling. The main inclusion criteria were age over 18 years and a confirmed, non-penetrating, acute TBI. BPPV-positive patients were randomly allocated to one of three interventions (repositioning manoeuvres, Brandt-Daroff exercises or advice) using minimisation criteria. Outcome assessors were blinded to the intervention.
UNASSIGNED: Of 2014 patients screened for inclusion, 180 were assessed for BPPV. Of those assessed, 34% (62/180) had BPPV, and 58 patients received an intervention. Therapist-led interventions were delivered safely and accurately according to intervention monitoring criteria. Resolution of BPPV was observed in 35/58 (60%) patients. The resolution rate was highest following repositioning manoeuvres (78%), followed by the advice (53%) and Brandt-Daroff interventions (42%). 10 patients experienced recurrence. This was observed more frequently in those with skull fractures and bilateral or mixed BPPV.
UNASSIGNED: Overall, the results provide strong evidence for the feasibility of a future trial. Therapist-led management of BPPV in acute TBI was safe and practicable. Repositioning manoeuvres seemingly yielded a superior treatment effect. However, given the high recurrence rate of post-traumatic BPPV, the optimal time to treat according to patients\' specific recurrence risk requires further investigation.
UNASSIGNED: ISRCTN91943864, https://doi.org/10.1186/ISRCTN91943864.
■这是一个多中心,三臂,平行组,随机化,可行性试验。招聘是通过便利抽样进行的。主要纳入标准是年龄在18岁以上,非穿透性,急性TBI。BPPV阳性患者被随机分配到三种干预措施之一(重新定位操作,Brandt-Daroff练习或建议)使用最小化标准。结果评估人员对干预措施视而不见。
■在接受纳入筛查的2014年患者中,180例进行了BPPV评估。在那些被评估的人中,34%(62/180)有BPPV,58名患者接受了干预。根据干预监测标准,治疗师主导的干预措施安全准确地交付。在35/58(60%)患者中观察到BPPV的消退。重新定位操作后的分辨率最高(78%),其次是建议(53%)和勃兰特-达洛夫干预(42%)。10例患者复发。在颅骨骨折和双侧或混合性BPPV的患者中更常见。
■总的来说,研究结果为未来试验的可行性提供了有力证据.在急性TBI中,治疗师主导的BPPV管理是安全可行的。重新定位动作似乎产生了优越的治疗效果。然而,鉴于创伤后BPPV的高复发率,根据患者特定复发风险的最佳治疗时间需要进一步调查.
■ISRCTN91943864,https://doi.org/10.1186/ISRCTN91943864.