Abstract：
OBJECTIVE: Persons with vestibular schwannoma suffer from dizziness, imbalance, and decreased function leading to reduced quality of life. Other forms of peripheral vestibular hypofunction show improvements in these signs and symptoms with vestibular rehabilitation; however, the efficacy of this intervention for those with vestibular schwannoma is unknown. Therefore, the aim of this systematic review was to determine the effect of vestibular physical therapy on subjective and objective measures of vestibular symptoms and function in people with vestibular schwannoma.
METHODS: Four electronic databases were searched: PubMed, CINAHL, EMBASE, and Cochrane. Included studies were experimental or observational in design and featured patients with vestibular schwannoma who had undergone vestibular physical therapy. Screening and quality assessment was completed independently by 2 researchers. Risk of bias was assessed with a tool appropriate for study design (eg, Cochrane Risk of Bias 2.0 tool for randomized trials). The Grading of Recommendations Assessment, Development and Evaluation approach was used to synthesize findings.
RESULTS: Twenty-three studies were included. Overall, the effect of vestibular physical therapy for patients with vestibular schwannoma was uncertain. Outcomes of dizziness, static and dynamic balance, and vestibular function all showed very low certainty on the Grading of Recommendations Assessment, Development and Evaluation assessment. Multimodal physical therapist interventions consistent with clinical practice guidelines (eg, gaze stability, habituation, balance training, gait training) demonstrated potential for improvement in dizziness, balance, and vestibular function, respectively. Results were mostly insignificant when a single modality was used.
CONCLUSIONS: There may be benefit in multimodal vestibular physical therapy for people with vestibular schwannoma to improve symptoms and function. More high-quality studies specific to vestibular schwannoma prehabilitation and rehabilitation are needed to increase the certainty in the evidence.
CONCLUSIONS: Physical therapists are encouraged to use multimodal vestibular rehabilitation for vestibular schwannoma in clinical practice in line with clinical guidelines for peripheral vestibular hypofunction.
METHODS: Four electronic databases were searched: PubMed, CINAHL, EMBASE, and Cochrane. Included studies were experimental or observational in design and featured patients with vestibular schwannoma who had undergone vestibular physical therapy. Screening and quality assessment was completed independently by 2 researchers. Risk of bias was assessed with a tool appropriate for study design (eg, Cochrane Risk of Bias 2.0 tool for randomized trials). The Grading of Recommendations Assessment, Development and Evaluation approach was used to synthesize findings.
RESULTS: Twenty-three studies were included. Overall, the effect of vestibular physical therapy for patients with vestibular schwannoma was uncertain. Outcomes of dizziness, static and dynamic balance, and vestibular function all showed very low certainty on the Grading of Recommendations Assessment, Development and Evaluation assessment. Multimodal physical therapist interventions consistent with clinical practice guidelines (eg, gaze stability, habituation, balance training, gait training) demonstrated potential for improvement in dizziness, balance, and vestibular function, respectively. Results were mostly insignificant when a single modality was used.
CONCLUSIONS: There may be benefit in multimodal vestibular physical therapy for people with vestibular schwannoma to improve symptoms and function. More high-quality studies specific to vestibular schwannoma prehabilitation and rehabilitation are needed to increase the certainty in the evidence.
CONCLUSIONS: Physical therapists are encouraged to use multimodal vestibular rehabilitation for vestibular schwannoma in clinical practice in line with clinical guidelines for peripheral vestibular hypofunction.
摘要：
目的：前庭神经鞘瘤患者有头晕，不平衡,功能下降导致生活质量下降。其他形式的外周前庭功能减退显示前庭康复改善了这些体征和症状；然而，这种干预对前庭神经鞘瘤患者的疗效尚不清楚.因此,本系统综述的目的是确定前庭物理治疗对前庭神经鞘瘤患者前庭症状和功能的主观和客观指标的影响。
方法：搜索了四个电子数据库：PubMed，CINAHL,EMBASE,还有Cochrane.纳入的研究是设计上的实验性或观察性研究，并以接受前庭物理治疗的前庭神经鞘瘤患者为特征。筛选和质量评价由2名研究者独立完成。使用适合研究设计的工具评估偏倚风险(例如，用于随机试验的Cochrane偏差风险2.0工具)。建议评估的分级，使用开发和评估方法来综合研究结果。
结果：纳入了23项研究。总的来说,前庭物理治疗对前庭神经鞘瘤患者的疗效尚不确定.头晕的结果，静态和动态平衡，和前庭功能在建议评估分级上都显示出非常低的确定性，发展和评价评估。与临床实践指南一致的多模式物理治疗师干预措施(例如，凝视稳定性，习惯,平衡训练,步态训练）证明了改善头晕的潜力，balance,和前庭功能，分别。当使用单一模式时，结果大多微不足道。
结论：对于患有前庭神经鞘瘤的患者，多模式前庭物理疗法可能对改善症状和功能有益。需要更多针对前庭神经鞘瘤康复和康复的高质量研究，以增加证据的确定性。
结论：鼓励物理治疗师在临床实践中使用多模式前庭康复治疗前庭神经鞘瘤，以符合周围性前庭功能减退的临床指南。
方法：搜索了四个电子数据库：PubMed，CINAHL,EMBASE,还有Cochrane.纳入的研究是设计上的实验性或观察性研究，并以接受前庭物理治疗的前庭神经鞘瘤患者为特征。筛选和质量评价由2名研究者独立完成。使用适合研究设计的工具评估偏倚风险(例如，用于随机试验的Cochrane偏差风险2.0工具)。建议评估的分级，使用开发和评估方法来综合研究结果。
结果：纳入了23项研究。总的来说,前庭物理治疗对前庭神经鞘瘤患者的疗效尚不确定.头晕的结果，静态和动态平衡，和前庭功能在建议评估分级上都显示出非常低的确定性，发展和评价评估。与临床实践指南一致的多模式物理治疗师干预措施(例如，凝视稳定性，习惯,平衡训练,步态训练）证明了改善头晕的潜力，balance,和前庭功能，分别。当使用单一模式时，结果大多微不足道。
结论：对于患有前庭神经鞘瘤的患者，多模式前庭物理疗法可能对改善症状和功能有益。需要更多针对前庭神经鞘瘤康复和康复的高质量研究，以增加证据的确定性。
结论：鼓励物理治疗师在临床实践中使用多模式前庭康复治疗前庭神经鞘瘤，以符合周围性前庭功能减退的临床指南。
