{"id":1340,"date":"2017-06-07T12:03:29","date_gmt":"2017-06-07T03:03:29","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1340"},"modified":"2017-06-07T12:03:29","modified_gmt":"2017-06-07T03:03:29","slug":"%e3%82%81%e3%81%be%e3%81%84%e4%bd%93%e6%93%8d%e3%81%ae%e5%8a%b9%e6%9e%9c","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1340","title":{"rendered":"\u3081\u307e\u3044\u4f53\u64cd\u306e\u52b9\u679c"},"content":{"rendered":"<p>\u2015\u6587\u732e\u540d\u2015<br \/>\nAdam W. A. Geraghty, PhD, et al. Internet based vestibular rehabilitations for older adults with chronic dizziness: a randomized controlled trial in primary care. Annals of family medicine. 2017; vol. 15, no. 3.<\/p>\n<p>\u2015\u8981\u7d04\u2015<br \/>\n<strong>Introduction\uff1a<\/strong><br \/>\n\u3000\u25cf\u3081\u307e\u3044\u306f\u3001\u983b\u5ea6\u306e\u9ad8\u3044\u75c7\u72b6\u3067\u3001\u30a2\u30e1\u30ea\u30ab\u3067\u53d7\u8a3a\u3059\u308b\u306e\u306f\u5e74\u9593\u304a\u3088\u305d700\u4e07\u4ef6\u3002<br \/>\n\u3000\u25cf\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u306b\u304a\u3044\u3066\u3001\u3081\u307e\u3044\u306e\u307b\u3068\u3093\u3069\u306e\u539f\u56e0\u306fBPPV\u3092\u542b\u3080\u524d\u5ead\u6a5f\u80fd\u969c\u5bb3\u3067\u3042\u308b\u3002<br \/>\n\u3000\u25cf\u9ad8\u9f62\u8005\u306e\u3081\u307e\u3044\u306f\u3001\u8ee2\u5012\u3001\u8ee2\u5012\u3078\u306e\u6050\u308c\u3001\u4e0d\u5b89\u3001\u3046\u3064\u306b\u95a2\u9023\u3057\u3001\u904b\u52d5\u969c\u5bb3\u3084\u30d5\u30ec\u30a4\u30eb\u3055\u306e\u5897\u5927\u3001\u81ea\u7acb\u3057\u305f\u751f\u6d3b\u304c\u5931\u308f\u308c\u308b\u306a\u3069\u306e\u7d50\u679c\u306b\u3064\u306a\u304c\u308b\u3002<br \/>\n\u3000\u25cf\u653e\u7f6e\u3055\u308c\u305f\u3081\u307e\u3044\u306f\u6162\u6027\u5316\u3057\u3001\u6700\u8fd1\u306e\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u306e\u7814\u7a76\u3067\u306f\u3001\u75c7\u72b6\u306e\u6301\u7d9a\u671f\u9593\u306f5.5\u5e74\u9593\u3060\u3063\u305f\u3002<br \/>\n\u3000\u25cf\u85ac\u7269\u6cbb\u7642\u3084\u5916\u79d1\u7684\u6cbb\u7642\u306f\u9650\u5b9a\u3055\u308c\u305f\u52b9\u679c\u3057\u304b\u306a\u3044\u304c\u3001\u3081\u307e\u3044\u4f53\u64cd\u306f\u524d\u5ead\u6a5f\u80fd\u969c\u5bb3\u306e\u60a3\u8005\u306b\u5bfe\u3057\u3066\u6709\u52b9\u3060\u3068\u3044\u3046\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u3042\u308b\u3002<br \/>\n\u3000\u3000\u7c21\u5358\u306a\u982d\u306e\u904b\u52d5\u3092\u3044\u304f\u3064\u304b\u884c\u3046\u3081\u307e\u3044\u4f53\u64cd\u306b\u3088\u3063\u3066\u3001\u4e2d\u67a2\u795e\u7d4c\u306e\u88dc\u5b8c\u3092\u4fc3\u3059\u3068\u3055\u308c\u3001\u7814\u7a76\u3067\u306f\u81ea\u5206\u3067\u884c\u3046\u3081\u307e\u3044\u4f53\u64cd\u3082\u52b9\u679c\u7684\u304b\u3082\u3057\u308c\u306a\u3044\u3068<br \/>\n\u3000\u3000\u793a\u5506\u3055\u308c\u3066\u3044\u305f\u3002<br \/>\n\u3000\u25cf\u30a4\u30f3\u30bf\u30fc\u30cd\u30c3\u30c8\u3092\u4f7f\u3046\u9ad8\u9f62\u8005\u306f\u5897\u52a0\u3057\u3066\u304a\u308a\u3001\u30a2\u30e1\u30ea\u30ab\u3067\u306e2013\u5e74\u306e\u8abf\u3079\u3067\u306f\u300165\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306e59%\u304c\u30a4\u30f3\u30bf\u30fc\u30cd\u30c3\u30c8\u3092\u5229\u7528\u3057\u3066\u3044\u308b\u3002<br \/>\n\u3000\u25cf\u4ee5\u4e0a\u3088\u308a\u3001\u30a4\u30f3\u30bf\u30fc\u30cd\u30c3\u30c8\u7d4c\u7531\u3067\u3081\u307e\u3044\u4f53\u64cd\u3092\u63d0\u4f9b\u3059\u308b\u3053\u3068\u304c\u52b9\u679c\u7684\u3067\u3042\u308b\u3068\u8a3c\u660e\u3055\u308c\u308c\u3070\u3001\u4f4e\u30b3\u30b9\u30c8\u306e\u3081\u307e\u3044\u306e\u6cbb\u7642\u3078\u306e\u30a2\u30af\u30bb\u30b9\u304c\u5897\u3048\u308b\u306e\u3067\u306f<br \/>\n\u3000\u3000\u306a\u3044\u304b\u3068\u8003\u3048\u305f\u3002<\/p>\n<p><strong>Method\uff1a<\/strong><br \/>\n\u25a0Setting and Participants<br \/>\n\u3000\u25cfsingle-center, single-blind randomized controlled trial<br \/>\n\u3000\u25cf2013\u5e749\u6708\u301c2014\u5e746\u6708<br \/>\n\u3000\u25cf\u30a4\u30ae\u30ea\u30b9\u5357\u90e8\u306e54\u306e\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u30fb\u30af\u30ea\u30cb\u30c3\u30af\u306e\u60a3\u8005<br \/>\n\u3000\u3010inclusion criteria\u3011<br \/>\n\u3000\u3000\u30fb\u904e\u53bb\uff12\u5e74\u9593\u306b\u3081\u307e\u3044\u3092\u4e3b\u8a34\u306b\u30af\u30ea\u30cb\u30c3\u30af\u3078\u53d7\u8a3a\u3057\u3066\u304a\u308a\u3001\u73fe\u5728\u3082\u982d\u3092\u52d5\u304b\u3059\u3068\u3081\u307e\u3044\u304c\u60aa\u5316\u3059\u308b<br \/>\n\u3000\u3000\u30fb\u30a4\u30f3\u30bf\u30fc\u30cd\u30c3\u30c8\u3078\u306e\u30a2\u30af\u30bb\u30b9\u304c\u3042\u308b\uff08\u30e1\u30fc\u30eb\u30a2\u30c9\u30ec\u30b9\u3082\u6301\u3063\u3066\u3044\u308b\uff09<br \/>\n\u3000\u3000\u30fb50\u6b73\u4ee5\u4e0a<br \/>\n\u3000\u3010exclusion criteria\u3011<br \/>\n\u3000\u3000\u30fb\u8033\u6027\u4ee5\u5916\u306e\u3081\u307e\u3044\u306e\u539f\u56e0\u304c\u3042\u308b<br \/>\n\u3000\u3000\u30fb\u3081\u307e\u3044\u4f53\u64cd\u3092\u3057\u3066\u306f\u3044\u3051\u306a\u3044\u72b6\u614b\u306b\u3042\u308b\uff08\u9838\u690e\u75c7\u306a\u3069\uff09<br \/>\n\u3000\u3000\u30fb\u751f\u547d\u306b\u5371\u967a\u304c\u3042\u308b\u72b6\u614b\u3001\u9032\u884c\u6027\u306e\u4e2d\u67a2\u795e\u7d4c\u75be\u60a3\u306a\u3069\u91cd\u75c7\u306a\u4f75\u5b58\u75be\u60a3\u304c\u3042\u308b<br \/>\n\u3000\u25cf\u5bfe\u8c61\u8005\u3078\u7814\u7a76\u8aac\u660e\u66f8\u3092\u9001\u308a\u3001\u8208\u5473\u304c\u3042\u308b\u4eba\u306b\u306f\u7814\u7a76\u30c1\u30fc\u30e0\u3078\u8fd4\u4fe1\u3057\u3066\u3082\u3089\u3046<br \/>\n\u3000\u25cf\u96fb\u8a71\u3067\u3081\u307e\u3044\u306e\u6301\u7d9a\u3001\u982d\u4f4d\u5909\u63db\u3067\u60aa\u5316\u3059\u308b\u304b\u3092\u78ba\u8a8d\u3002Epley\u6cd5\u3067\u306e\u6cbb\u7642\u6b74\u304c\u3042\u308b\u60a3\u8005\u306f\u9664\u5916\u3002<\/p>\n<p>\u25a0Randomization and Interventions<br \/>\n\u3000\u25cf\u30a4\u30f3\u30bf\u30fc\u30cd\u30c3\u30c8\u306e\u30bd\u30d5\u30c8\u30a6\u30a7\u30a2\u3067\u3001\uff12\u3064\u306e\u30b0\u30eb\u30fc\u30d7\uff08internet-based\u3081\u307e\u3044\u4f53\u64cd\u30fb\u30b0\u30eb\u30fc\u30d7\u3068usual care\u30fb\u30b0\u30eb\u30fc\u30d7\uff09<br \/>\n\u3000 \u306b\u30e9\u30f3\u30c0\u30e0\u306b\u5272\u4ed8<br \/>\n\u3000\u3010internet-based\u3081\u307e\u3044\u4f53\u64cd\u3011<br \/>\n\u3000\u3000\u30fbBalance Retraining(<a href=\"https:\/\/balance.lifeguidehealth.org\">https:\/\/balance.lifeguidehealth.org<\/a>)<br \/>\n\u3000\u3000\u30fb\u3081\u307e\u3044\u306e\u30e1\u30ab\u30cb\u30ba\u30e0\u306b\u3064\u3044\u3066\u306e\u8aac\u660e\u304b\u3089\u59cb\u307e\u308a\u3001\uff16\u3064\u306e\u30bb\u30c3\u30b7\u30e7\u30f3\u304c\u3042\u308b<br \/>\n\u3000\u3000\u30fb\uff11\u9031\u9593\u6bce\u306b\u65b0\u3057\u3044\u30bb\u30c3\u30b7\u30e7\u30f3\u3092\u898b\u3089\u308c\u308b<br \/>\n\u3000\u3000\u30fb\u500b\u4eba\u306e\u75c7\u72b6\u306b\u57fa\u3065\u3044\u3066\u3081\u307e\u3044\u4f53\u64cd\u304c\u51e6\u65b9\u3055\u308c\u308b\u3002<br \/>\n\u3000\u3000\u30fb\u4f53\u64cd\u306f\u3001\u982d\u3092\u4e0a\u4e0b\u30fb\u5de6\u53f3\u306b\u52d5\u304b\u3059\u904b\u52d5\uff08\u2192exercise instruction\u53c2\u7167\uff09<br \/>\n\u3000\u3000\u30fb\u30ea\u30e9\u30af\u30bc\u30fc\u30b7\u30e7\u30f3\u3084\u547c\u5438\u6cd5\u3001\u8a8d\u77e5\u518d\u69cb\u6210\u306a\u3069\u3001\u8a8d\u77e5\u884c\u52d5\u7642\u6cd5\u306e\u5185\u5bb9\u3082\u6bce\u9031\u53d6\u308a\u5165\u308c\u3089\u308c\u3066\u3044\u308b<br \/>\n\u3000\u3010usual care\u3011<br \/>\n\u3000\u3000\u30fb\u5236\u5410\u5264\u306a\u3069\u306e\u5bfe\u75c7\u7642\u6cd5\u3001\u6559\u80b2\u7528\u30d1\u30f3\u30d5\u30ec\u30c3\u30c8\u306a\u3069<\/p>\n<p>\u25a0Outcome measures<br \/>\n\u3000\u25cfprimary outcome\u306f\u3001\uff16\u30f6\u6708\u5f8c\u306eVSS-SF\u30b9\u30b3\u30a2<br \/>\n\u3000\u25cf\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u3001\uff13\u30f6\u6708\u5f8c\u3001\uff16\u30f6\u6708\u5f8c\u306b\u4ee5\u4e0b\u306e\uff13\u3064\u306e\u6307\u6a19\u3092\u6e2c\u5b9a<br \/>\n\u3000\u3000\u2460VSS-SF(vertigo symptom scale-short form)\uff1b\u3081\u307e\u3044\u306b\u95a2\u9023\u3059\u308b15\u306e\u75c7\u72b6\u306e\u983b\u5ea6\u306b\u3064\u3044\u3066\u306e\u30b9\u30b3\u30a2<br \/>\n\u3000\u3000\u3000\u30fbVSS-SF subscale score<br \/>\n\u3000\u3000\u3000\u30fbVSS-SF autonomic symptom subscale score<br \/>\n\u3000\u3000\u2461DHI(dizziness handicap inventory)\uff1a\u3081\u307e\u3044\u306b\u3088\u308b\u8eab\u4f53\u7684\u3001\u611f\u60c5\u7684\u3001\u6a5f\u80fd\u7684\u5f71\u97ff\u3092\u6e2c\u308b\u30b9\u30b3\u30a2<br \/>\n\u3000\u3000\u2462HADA(hospital anxiety and depression scale)\uff1a\u4e0d\u5b89\u3084\u3046\u3064\u3092\u6e2c\u308b\u30b9\u30b3\u30a2<\/p>\n<p>\u25a0Statistical analysis<br \/>\n\u3000\u25cfStata\/SE version 13.1\u4f7f\u7528<br \/>\n\u3000\u25cfprimary analysis\u3067\u306fintention-to-treat\u89e3\u6790\u3001secondary per-protocol analysis\u3067\u306f\u6cbb\u7642\u30a2\u30c9\u30d2\u30a2\u30e9\u30f3\u30b9\u3092\u8003\u616e\u3057\u3001<br \/>\n\u3000\u3000\u5c11\u306a\u304f\u3068\u3082\uff11\u56de\u4ee5\u4e0a\u30bb\u30c3\u30b7\u30e7\u30f3\u3092\u5b8c\u4e86\u3057\u305f\u4eba\u3092\u5bfe\u8c61\u306b\u89e3\u6790\u3057\u305f\u3002<\/p>\n<p><strong>Results\uff1a<\/strong><br \/>\n \u25cfTable1. Baseline characteristics<br \/>\n \u25cfFigure1. Patient flow through the trial<br \/>\n\u3000\u30fb\u4ecb\u5165\u7fa4\u3067\u8131\u843d\u7387\u304c\u9ad8\u3044<br \/>\n \u25cfTable2. Primary and secondary outcome measures at 3 and 6 months<br \/>\n\u3000\u30fb\u591a\u91cd\u4ee3\u5165\u89e3\u6790\u3092\u884c\u3063\u305f\u7d50\u679c\u3067\u306f\u3001VSS-SF\u306f3\u30f6\u6708\u5f8c\u306b\u6709\u610f\u306a\u4f4e\u4e0b\u3092\u793a\u3057\u305f(2.57points; 95%CI, 0.85 to 4.28, P=.003)\u304c\u3001<br \/>\n\u3000\u30006\u30f6\u6708\u5f8c\u306b\u306f\u6709\u610f\u306a\u4f4e\u4e0b\u306f\u793a\u3055\u306a\u304b\u3063\u305f(1.86points; 95%CI, -0.59 to 4.32, P=.14)\u3002<br \/>\n\u3000\u30fbper-protocol analysis\u3067\u306f\u4ecb\u5165\u7fa4160\u4eba\u306e\u3046\u306199\u4eba\u304c\u8a72\u5f53\u3002Primary outcome\u306f\uff13\u30f6\u6708\u5f8c\u3067\u306fVSS-SF\u306e\u6709\u610f\u306a\u4f4e\u4e0b\u306f\u898b\u3089\u308c\u306a\u304b\u3063\u305f<br \/>\n\u3000\u3000(1.27point; 95%CI, -0.31 to 2.85, P=.12)\u304c\u3001\uff16\u30f6\u6708\u5f8c\u306b\u306f\u6709\u610f(2.11points; 95%CI, 0.23 to 3.99, P=.03)\u3068\u306a\u3063\u305f\u3002<br \/>\n \u25cfTable.3 post hoc exploratory analysis of intervention effectiveness by age<\/p>\n<p><strong>Discussion\uff1a<\/strong><br \/>\n \u25cf\u4eca\u56de\u306e\u77e5\u898b\u306f\u3001\u4ee5\u524d\u306ebooklet-based\u3081\u307e\u3044\u4f53\u64cd\u3001face-to-face\u3081\u307e\u3044\u4f53\u64cd\u306e\u7d50\u679c\u306b\u5339\u6575\u3059\u308b\u3002<br \/>\n \u25cf\u4eca\u56de\u306e\u7814\u7a76\u306e\u9650\u754c<br \/>\n\u3000\u30fb\u7814\u7a76\u306b\u62db\u5f85\u3055\u308c\u305f\u60a3\u8005\u306e\u3046\u306110%\u4ee5\u4e0b\u306e\u53c2\u52a0\u7387<br \/>\n\u3000\u30fb\u4ecb\u5165\u7fa4\u306e\u8131\u843d\u7387\u304c\u6bd4\u8f03\u7684\u9ad8\u3044\u3002<br \/>\n\u3000\u30fb\u3081\u307e\u3044\u306e\u539f\u56e0\u6bce\u306e\u5206\u6790\u304c\u3067\u304d\u3066\u3044\u306a\u3044<br \/>\n\u3000\u30fb\u6709\u5bb3\u4e8b\u8c61\u304c\u5831\u544a\u3055\u308c\u306a\u304b\u3063\u305f\u53ef\u80fd\u6027\u304c\u3042\u308b<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u3011<br \/>\n\u30002017\u5e746\u67087\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u2015\u6587\u732e\u540d\u2015 Adam W. A. Geraghty, PhD, et al. Internet based vestibular rehabilitations for older adults with chronic &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1340\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u3081\u307e\u3044\u4f53\u64cd\u306e\u52b9\u679c<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-1340","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1340","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1340"}],"version-history":[{"count":4,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1340\/revisions"}],"predecessor-version":[{"id":1344,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1340\/revisions\/1344"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1340"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1340"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1340"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}