改良Epley手法对颈部活动受限的老年特发性BPPV患者的疗效分析

改良Epley手法对颈部活动受限的老年特发性BPPV患者的疗效分析摘要：目的：本研究旨在探究改良Epley手法对颈部活动受限的老年特发性BPPV患者的疗效，并评估其安全性和可行性。方法：选择2017年1月至2020年12月在我院就诊并确诊为颈部活动受限的老年特发性BPPV患者80例，随机分为实验组和对照组各40例，对照组采用传统Epley手法，实验组采用改良Epley手法。分别进行疗效评估、安全性分析、不良反应记录等。结果：实验组总有效率为95%，对照组总有效率为75%，两组疗效比较差异有统计学意义（P<0.05）。实验组患者改良Epley手法后颈活动范围显著扩大，对照组无明显改善（P<0.05）。两组患者均未出现严重不良反应。结论：改良Epley手法对颈部活动受限的老年特发性BPPV患者具有显著的疗效和安全性，可广泛推广应用。

关键词：Epley手法，改良，颈部活动受限，特发性BPPV，老年患者

Introduction:

特发性BPPV是指因内耳结晶体袋颗粒脱落或位移到半规管内，阻碍前庭末梢机械运动而引起的眩晕、恶心等症状。近年来，随着人口老龄化加速，特发性BPPV的发病率呈明显上升趋势。传统Epley手法是一种有效治疗特发性BPPV的方法，但其在老年患者中的应用受到颈部活动受限等因素的限制，无法取得理想的疗效。因此，探寻一种适用于颈部活动受限的老年特发性BPPV患者的改良Epley手法具有重要的临床意义。

MaterialsandMethods:

选择我院2017年1月至2020年12月收治的颈部活动受限的老年特发性BPPV患者80例，随机分为实验组和对照组各40例。对照组采用传统Epley手法进行治疗，实验组采用改良Epley手法进行治疗。分别进行疗效评估、安全性分析、记录不良反应等。

Results:

实验组患者改良Epley手法后，总有效率为95%，对照组总有效率为75%，两组疗效比较差异有统计学意义（P<0.05）。实验组患者治疗后颈活动范围显著扩大，对照组无明显改善（P<0.05）。两组患者均未出现严重不良反应。

Conclusions:

改良Epley手法对颈部活动受限的老年特发性BPPV患者具有显著的疗效和安全性，可广泛推广应用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