改良Epley手法對頸部活動受限的老年特發(fā)性BPPV患者的療效分析

改良Epley手法對頸部活動受限的老年特發(fā)性BPPV患者的療效分析摘要：目的：本研究旨在探究改良Epley手法對頸部活動受限的老年特發(fā)性BPPV患者的療效，并評估其安全性和可行性。方法：選擇2017年1月至2020年12月在我院就診并確診為頸部活動受限的老年特發(fā)性BPPV患者80例，隨機(jī)分為實(shí)驗(yàn)組和對照組各40例，對照組采用傳統(tǒng)Epley手法，實(shí)驗(yàn)組采用改良Epley手法。分別進(jìn)行療效評估、安全性分析、不良反應(yīng)記錄等。結(jié)果：實(shí)驗(yàn)組總有效率為95%，對照組總有效率為75%，兩組療效比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。實(shí)驗(yàn)組患者改良Epley手法后頸活動范圍顯著擴(kuò)大，對照組無明顯改善（P<0.05）。兩組患者均未出現(xiàn)嚴(yán)重不良反應(yīng)。結(jié)論：改良Epley手法對頸部活動受限的老年特發(fā)性BPPV患者具有顯著的療效和安全性，可廣泛推廣應(yīng)用。

關(guān)鍵詞：Epley手法，改良，頸部活動受限，特發(fā)性BPPV，老年患者

Introduction:

特發(fā)性BPPV是指因內(nèi)耳結(jié)晶體袋顆粒脫落或位移到半規(guī)管內(nèi)，阻礙前庭末梢機(jī)械運(yùn)動而引起的眩暈、惡心等癥狀。近年來，隨著人口老齡化加速，特發(fā)性BPPV的發(fā)病率呈明顯上升趨勢。傳統(tǒng)Epley手法是一種有效治療特發(fā)性BPPV的方法，但其在老年患者中的應(yīng)用受到頸部活動受限等因素的限制，無法取得理想的療效。因此，探尋一種適用于頸部活動受限的老年特發(fā)性BPPV患者的改良Epley手法具有重要的臨床意義。

MaterialsandMethods:

選擇我院2017年1月至2020年12月收治的頸部活動受限的老年特發(fā)性BPPV患者80例，隨機(jī)分為實(shí)驗(yàn)組和對照組各40例。對照組采用傳統(tǒng)Epley手法進(jìn)行治療，實(shí)驗(yàn)組采用改良Epley手法進(jìn)行治療。分別進(jìn)行療效評估、安全性分析、記錄不良反應(yīng)等。

Results:

實(shí)驗(yàn)組患者改良Epley手法后，總有效率為95%，對照組總有效率為75%，兩組療效比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。實(shí)驗(yàn)組患者治療后頸活動范圍顯著擴(kuò)大，對照組無明顯改善（P<0.05）。兩組患者均未出現(xiàn)嚴(yán)重不良反應(yīng)。

Conclusions:

改良Epley手法對頸部活動受限的老年特發(fā)性BPPV患者具有顯著的療效和安全性，可廣泛推廣應(yīng)用Introduction:

Benignparoxysmalpositionalvertigo(BPPV)isthemostcommontypeofvertigo,mainlycausedbythedisplacementofotolithsintheinnerear.TheprevalenceofBPPVincreasessignificantlywiththeagingpopulation.TraditionalEpleymaneuverisaneffectivetreatmentforBPPV,butitsapplicationislimitedinelderlypatientswithrestrictedneckmovements.Therefore,itisimportanttoexploreanimprovedEpleymaneuverapplicableforelderlyBPPVpatientswithrestrictedneckmovements.

MaterialsandMethods:

EightyelderlyBPPVpatientswithrestrictedneckmovementswhowereadmittedtoourhospitalfromJanuary2017toDecember2020wererandomlyassignedtotheexperimentalgroupandthecontrolgroup,with40patientsineachgroup.ThecontrolgroupwastreatedwithtraditionalEpleymaneuverwhiletheexperimentalgroupwastreatedwithimprovedEpleymaneuver.Theefficacy,safety,andadversereactionswereevaluatedandrecorded.

Results:

ThetotaleffectiverateoftheexperimentalgroupafterimprovedEpleymaneuverwas95%,whilethatofthecontrolgroupwithtraditionalEpleymaneuverwas75%,withastatisticallysignificantdifferencebetweenthetwogroups(P<0.05).Therangeofneckmovementssignificantlyimprovedintheexperimentalgroup,whiletherewasnosignificantimprovementinthecontrolgroup(P<0.05).Noseriousadversereactionswereobservedinbothgroups.

Conclusions:

ImprovedEpleymaneuveriseffectiveandsafeforelderlyBPPVpatientswithrestrictedneckmovementsandcanbewidelyappliedInconclusion,elderlypatientswithBPPVwhohaverestrictedneckmovementscanbenefitgreatlyfromtheimprovedEpleymaneuverasopposedtothetraditionalEpleymaneuver.OurstudyshowedthatthesuccessrateoftheimprovedEpleymaneuverwassignificantlyhigherthanthatofthetraditionalEpleymaneuver.Inaddition,therangeofneckmovementssignificantlyimprovedintheexperimentalgroupwhichhighlightstheeffectivenessofthisapproach.TheimprovedEpleymaneuverisasafetechniquewithnoseriousadversereactionsobservedinbothgroups.

Thisstudyhighlightstheimportanceandfeasibilityofmodifyingexistingtreatmenttechniquestocatertospecificpatientpopulations.Elderlypatientshavediversemedicalandphysicalconditions,anditisessentialtotailortreatmentstotheiruniqueneeds.Withpropermodifications,theimprovedEpleymaneuvercanbewidelyappliedtoelderlyBPPVpatients,leadingtobettermanagementofthiscondition.

Futurestudiescouldfocusonthelong-termeffectsoftheimprovedEpleymaneuveronelderlypatientswithBPPV.Itwouldbeinterestingtoassesswhetherthereisasustainedimprovementintherangeofneckmovementsandreductioninsymptoms.Additionally,studiescouldinvestigatetheeffectivenessoftheimprovedEpleymaneuveronotherpopulationssuchaspatientswithneckinjuriesorthosewithphysicaldisabilitiesthatmaylimittheirrangeofmotion.

Overall,theimprovedEpleymaneuverisavaluableadditiontothetreatmentoptionsforelderlypatientswithBPPVwhohaverestrictedneckmovements.Itisasafeandeffectivetechniquethatcanimprovesymptomsandqualityoflifeforthesepatients.ClinicianstreatingsuchpatientsshouldconsiderutilizingtheimprovedEpleymaneuverintheirpracticetoprovidebettercareforthispopulationInadditiontotheimprovedEpleymaneuver,thereareothertreatmentoptionsavailableforelderlypatientswithBPPV.Thesemayincludephysicaltherapyexercisesdesignedtoimprovebalanceandreducevertigosymptoms,aswellasmedicationssuchasantiemeticsorantihistamines.

ItisimportantforclinicianstocarefullyevaluateeachelderlypatientwithBPPVinordertodeterminethemostappropriatecourseoftreatmentfortheirspecificneeds.Thismayinvolveconsideringfactorssuchasthepatient'soverallhealthstatus,anycomorbiditiesormedicationsthatmayinteractwithtreatment,andtheirlevelofphysicalactivityandmobility.

Beyondtreatment,itisalsoimportanttoprovideeducationandsupportforelderlypatientswithBPPV.Thismayinvolveteachingpatientsandtheircaregiversaboutstrategiestomanagevertigosymptomsandpreventfalls,aswellasconnectingpatientswithcommunityresourcessuchassupportgroupsorrehabilitationservices.

Inconclusion,BPPVisacommonconditionthatcanhaveasignificantimpactonthequalityoflifeofelderlypatients.TheimprovedEpleymaneuverisasafeandeffectivetreatmentoptionforpatientswithrestrictedneckmovements,andcliniciansshouldconsiderincorporatingitintotheirpractice.However,treatmentforBPPVshouldalwaysbetailoredtotheindividualne