背景:儿童完全或部分未代偿性前庭功能障碍的后果通常是平衡障碍,有跌倒和疲劳增加的风险,特别是在需要姿势控制的任务期间。这些建议的目的是为前庭损伤儿童建立前庭康复(VR)指南。
方法:指南是在对国际文献进行系统回顾的基础上制定的,由讲法语的耳鼻喉科医生的多学科小组验证,科学家,和物理治疗师。它们被列为A级,B,C,或根据科学证据水平下降的专家意见。
结果:PubMed搜索了1990年1月至2021年12月之间发表的研究,使用关键词“前庭,\"\"康复,\"和\"children\"。过滤和审阅文章后,共纳入10份出版物以确立建议。
结论:建议在VR之前进行前庭评估,包括前庭眼反射的研究,耳石功能,和姿势控制。在前庭功能障碍的情况下,建议从早期开始进行物理治疗,以训练姿势控制的不同方面,包括预期和反应姿势调整。适用于儿科人群的VR被推荐用于前庭功能障碍导致患有头部创伤的人的功能性疾病或眩晕症状的儿童。建议使用注视稳定练习来适应和替代双侧前庭障碍的儿童。不建议对儿童和青少年进行光运动刺激和虚拟现实。
BACKGROUND: The consequence of complete or partial uncompensated vestibular dysfunction in children is usually balance disorders, with the risk of falls and increased fatigue, particularly during tasks requiring postural control. The aim of these recommendations is to establish guidelines for vestibular rehabilitation (VR) in children with vestibular impairment.
METHODS: The guidelines were developed based on a systematic
review of the international literature, validated by a multidisciplinary group of French-speaking otorhinolaryngologists, scientists, and physiotherapists. They are classified as grade A, B, C, or expert opinion according to a decreasing level of scientific evidence.
RESULTS: A PubMed search of studies published between January 1990 and December 2021 was carried out using the keywords \"vestibular,\" \"rehabilitation,\" and \"children\". After filtering and reviewing the articles, a total of 10 publications were included to establish the recommendations.
CONCLUSIONS: It is recommended that a vestibular assessment be carried out before VR, including a study of vestibulo-ocular reflex, otolithic function, and postural control. In cases of vestibular dysfunction, physiotherapy treatment is recommended from an early age to train different aspects of postural control, including anticipatory and reactive postural adjustments. VR adapted to the pediatric population is recommended for children whose vestibular dysfunction leads to functional disorders or symptoms of vertigo for those who have suffered head trauma. It is recommended that children with bilateral vestibular impairment be treated using gaze stabilization exercises for adaptation and substitution. Optokinetic stimulation and virtual reality are not recommended for children and young adolescents.